BACKGROUND: This study explores intersectionality in moral distress and turnover intention among healthcare workers (HCWs) in British Columbia, focusing on race and gender dynamics. It addresses gaps in research on how these factors affect healthcare workforce composition and experiences.
METHODS: Our cross-sectional observational study utilized a structured online survey. Participants included doctors, nurses, and in-home/community care providers. The survey measured moral distress using established scales, assessed coping mechanisms, and evaluated turnover intentions. Statistical analysis examined the relationships between race, gender, moral distress, and turnover intention, focusing on identifying disparities across different healthcare roles. Complex interactions were examined through Classification and Regression Trees.
RESULTS: Racialized and gender minority groups faced higher levels of moral distress. Profession played a significant role in these experiences. White women reported a higher intention to leave due to moral distress compared to other groups, especially white men. Nurses and care providers experienced higher moral distress and turnover intentions than physicians. Furthermore, coping strategies varied across different racial and gender identities.
CONCLUSIONS: Targeted interventions are required to mitigate moral distress and reduce turnover, especially among healthcare workers facing intersectional inequities.

BACKGROUND: In Chinese culture, the concept of Mianzi holds significant importance in interpersonal interactions. Mianzi represents one\'s social standing, dignity, and reputation, influencing behaviors and decisions within various contexts. Mianzi consciousness manifests in two primary forms: proactive and defensive. Proactive Mianzi consciousness involves efforts to enhance one\'s social image, while defensive Mianzi consciousness focuses on protecting one\'s existing reputation. Analyzing the impact of the two Mianzi consciousness dimensions on individuals\' attitudes and behaviors is effective for understanding interpersonal dynamics in China. This study specifically examined the relationship between high Mianzi consciousness congruence and unethical pro-organizational behavior (UPB). UPB refers to actions taken by employees that are intended to benefit their organization but are unethical or morally questionable. By investigating how congruence in proactive and defensive Mianzi consciousness influences the likelihood of engaging in UPB, this research aimed to uncover the underlying social and psychological mechanisms driving such behavior.
METHODS: Employing polynomial regression and response surface analysis method, this study developed a model that combines the proactive Mianzi consciousness and the defensive Mianzi consciousness into different Mianzi management strategies and tested the relationship between high Mianzi consciousness congruence and UPB.
RESULTS: Sample data collected at two time points one month apart supported all hypotheses. Specifically, the findings revealed that high levels of Mianzi consciousness congruence (i.e., all-around type in Mianzi management strategies) positively relate to UPB, and verified the mediation effect of external work locus of control and the moderation effect of relational psychological contract.
CONCLUSIONS: This research advanced a novel, synergistic perspective on the role of social Mianzi and contributed to the localized UPB research, thus helping to find a path to prevent UPB from occurring in the Chinese sociocultural context.

Witnesses of moral violations stand up for their moral principles, despite facing substantial costs for intervening. Notwithstanding its importance, little is known whether responsibility attributions and the relation between the victim and a witness (i.e., kinship) have different effects on the intention to intervene in situations of different severity (e.g., moral courage situations). We predict an interaction between the situation\'s severity and the victims\' responsibility for their plight. In less-severe situations, witnesses would be less willing to help when they perceive the victim to be responsible for their plight. However, those who are not seen as responsible would receive more help. For more-severe situations, responsibility is predicted to have no effect. Opposite effects are predicted for the relationship between the helper and the victim. We further predict that perceived costs for helping mediates witnesses\' willingness to intervene. Two studies showed that people are more willing to help individuals who are perceived as being innocent, but only in less-severe situations. In more-severe situations, people\'s willingness to intervene increases, regardless of responsibility attributions. We did not observe effects for kinship. Moreover, we provide partial evidence that witnesses of more-severe situations indeed accept higher costs for intervention.

I defend the claim that life-suspending technologies can constitute a catastrophic and existential security factor for risks structurally similar to those related to climate change. The gist of the argument is that, under certain conditions, life-suspending technologies such as cryonics can provide self-interested actors with incentives to efficiently tackle such risks-in particular, they provide reasons to overcome certain manifestations of generational egoism, a risk factor of several catastrophic and existential risks. Provided we have reasons to decrease catastrophic and existential risks such as climate change, we also have a (defeasible) reason for investing in developing and making life-suspending technologies (more) widespread.

This paper investigates the ethical implications of applying open science (OS) practices on disruptive technologies, such as generative AIs. Disruptive technologies, characterized by their scalability and paradigm-shifting nature, have the potential to generate significant global impact, and carry a risk of dual use. The tension arises between the moral duty of OS to promote societal benefit by democratizing knowledge and the risks associated with open dissemination of disruptive technologies. Van Rennselaer Potter\'s \'third bioethics\' serves as the founding horizon for an ethical framework to govern these tensions. Through theoretical analysis and concrete examples, this paper explores how OS can contribute to a better future or pose threats. Finally, we provide an ethical framework for the intersection between OS and disruptive technologies that tries to go beyond the simple \'as open as possible\' tenet, considering openness as an instrumental value for the pursuit of other ethical values rather than as a principle with prima facie moral significance.

The COVID-19 pandemic deeply affected healthcare workers, although the impact may have differed according to different workplace contexts. The aim of this current research was to compare the psychopathology presented by hospital versus nursing home healthcare workers during the COVID-19 pandemic and to analyse the predictive role of purpose in life and moral courage in the appearance of psychopathology. This was an observational, cross-sectional study carried out on a sample of 108 healthcare workers, 54 each from a hospital or nursing homes, who were recruited during the 5 and 6th waves of the COVID-19 pandemic in Spain. Various self-reported scales were used to assess anxiety, depression, acute/post-traumatic stress disorder, drug and alcohol abuse, burnout, purpose in life, and moral courage. Compared to the hospital healthcare workers, nursing home healthcare workers had higher scores and a higher prevalence of anxiety (74.1% vs. 42%), depression (40.7% vs. 14.8%), and post-traumatic stress disorder (55.6% vs. 25.9). In the overall sample, purpose in life was a protective factor against psychopathology (OR = 0.54) and burnout (OR = 0.48); moral courage was a protective factor against depression (OR = 0.47) and acute stress (OR = 0.45); and exposure of family/friends to SARS-CoV-2 was a risk factor for acute stress (OR = 2.24), post-traumatic stress disorder (OR = 1.33), and higher burnout depersonalisation subscale scores (OR = 1.84). In conclusion, the increased presence of psychopathology in nursing home healthcare workers may be influenced by workplace and occupational contexts, personal factors such as exposure of family/friends to SARS-CoV-2, or internal dimensions such as purpose in life and moral courage. This knowledge could be useful for understanding how a future epidemic or pandemic might affect the mental health of healthcare workers in different labour contexts.

Belief in powerful supernatural agents that enforce moral norms has been theoretically linked with cooperative altruism and prosociality. Correspondingly, prior research reveals an implicit association between atheism and extreme antisociality (e.g., serial murder). However, findings centered on associations between lack of faith and moral transgression do not directly address the hypothesized conceptual association between religious belief and prosociality. Accordingly, we conducted two pre-registered experiments depicting a \"serial helper\" to assess biases related to extraordinary helpfulness, mirroring designs depicting a serial killer used in prior cross-cultural work. In both a predominantly religious society (the U.S., Study 1) and a predominantly secular society (New Zealand, Study 2), we successfully replicated previous research linking atheism with transgression, and obtained evidence for a substantially stronger conceptual association between religiosity and virtue. The results suggest that stereotypes linking religiosity with prosociality are both real and global in scale.

UNASSIGNED: Moral distress occurs when individuals feel powerless to do what they think is right, including when clinicians are prevented from providing health care they deem necessary. The loss of federal protections for abortion following the Dobbs v Jackson Women\'s Health Organization Supreme Court decision may place clinicians providing abortion at risk of experiencing moral distress, as many could face new legal and civil penalties for providing care in line with professional standards and that they perceive as necessary.
UNASSIGNED: To assess self-reported moral distress scores among abortion-providing clinicians following the Dobbs decision overall and by state-level abortion policy.
UNASSIGNED: This survey study, conducted from May to December 2023, included US abortion-providing clinicians (physicians, advanced practice clinicians, and nurses). A purposive electronic survey was disseminated nationally through professional listservs and snowball sampling.
UNASSIGNED: Abortion policy in each respondent\'s state of practice (restrictive vs protective using classifications from the Guttmacher Institute).
UNASSIGNED: Using descriptive statistics and unadjusted and adjusted negative binomial regression models, the association between self-reported moral distress on the Moral Distress Thermometer (MDT), a validated psychometric tool that scores moral distress from 0 (none) to 10 (worst possible), and state abortion policy was examined.
UNASSIGNED: Overall, 310 clinicians (271 [87.7%] women; mean [SD] age, 41.4 [9.7] years) completed 352 MDTs, with 206 responses (58.5%) from protective states and 146 (41.5%) from restrictive states. Reported moral distress scores ranged from 0 to 10 (median, 5) and were more than double for clinicians in restrictive compared with protective states (median, 8 [IQR, 6-9] vs 3 [IQR, 1-6]; P < .001). Respondents with higher moral distress scores included physicians compared with advanced practice clinicians (median, 6 [IQR, 3-8] vs 4 [IQR, 2-7]; P = .005), those practicing in free-standing abortion clinics compared with those practicing in hospitals (median, 6 [IQR, 3-8] vs 4 [IQR, 2-7]; P < .001), those no longer providing abortion care compared with those still providing abortion care (median, 8 [IQR, 4-9] vs 5 [IQR, 2-8]; P = .004), those practicing in loss states (states with the greatest decline in abortion volume since the Dobbs decision) compared with those in stable states (unadjusted incidence rate [IRR], 1.72 [95% CI, 1.55-1.92]; P < .001; adjusted IRR, 1.59 [95% CI, 1.40-1.79]; P < .001), and those practicing in surge states (states with the greatest increase in abortion volume since the Dobbs decision) compared with those in stable states (unadjusted IRR, 1.27 [95% CI, 1.11-1.46]; P < .001; adjusted IRR, 1.24 [95% CI, 1.09-1.41]; P = .001).
UNASSIGNED: In this purposive national survey study of clinicians providing abortion, moral distress was elevated among all clinicians and more than twice as high among those practicing in states that restrict abortion compared with those in states that protect abortion. The findings suggest that structural changes addressing bans on necessary health care, such as federal protections for abortion, are needed at institutional, state, and federal policy levels to combat widespread moral distress.

In this article, I interrogate whether the deployment and development of the Metaverse should take into account African values and modes of knowing to foster the uptake of this hyped technology in Africa. Specifically, I draw on the moral norms arising from the components of communal interactions and humanness in Afro-communitarianism to contend that the deployment of the Metaverse and its development ought to reflect core African moral values to foster its uptake in the region. To adequately align the Metaverse with African core values and thus foster its uptake among Africans, significant technological advancement that makes simulating genuine human experiences possible must occur. Additionally, it would be necessary for the developers and deployers to ensure that higher forms of spiritual activities can be had in the Metaverse to foster its uptake in Africa. Finally, I justify why the preceding points do not necessarily imply that the Metaverse will have a higher moral status than real life on the moral scale that can be grounded in Afro-communitarianism.

BACKGROUND: Historically, epidemics have been accompanied by the concurrent emergence of stigma, prejudice, and xenophobia. This scoping review aimed to describe and map published research targeting ethical values concerning monkeypox (mpox). In addition, it aimed to understand the research gaps related to mpox associated stigma.
METHODS: We comprehensively searched databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Ovid, and Google Scholar) to identify published literature concerning mpox ethical issues and stigma from May 6, 2022, to February 15, 2023. The key search terms used were \"monkeypox\", \"ethics\", \"morals\", \"social stigma\", \"privacy\", \"confidentiality\", \"secrecy\", \"privilege\", \"egoism\", and \"metaethics\". This scoping review followed the framework proposed by Arksey and O\'Malley in 2005 and was further improved by the recommendations of Levac et al. in 2010.
RESULTS: The search strategies employed in the scoping review yielded a total of 454 articles. We analyzed the sources, types, and topics of the retrieved articles/studies. The authors were able to identify 32 studies that met inclusion criteria. Six of the 32 included studies were primary research. The study revealed that the ongoing mpox outbreak is contending with a notable surge in misinformation and societal stigma. It highlights the adverse impacts of stigma and ethical concerns associated with mpox, which can negatively affect people with the disease.
CONCLUSIONS: The study\'s findings underscore the imperative need to enhance public awareness; involve civil society; and promote collaboration among policymakers, medical communities, and social media platforms. These collective endeavors are crucial for mitigating stigma, averting human-to-human transmission, tackling racism, and dispelling misconceptions associated with the outbreak.