It examines moral residue (MR); the distress experience common among health care practitioners as well as other moral agents of recognizing what they take to be their own failure to meet a moral requirement, despite not being fully blameworthy for that failure; and which they express through regret or anguish.
About the project
Ten years ago I decided to change the way I was teaching medical ethics by turning to artistic representations of moral situations, and notably situations of unavoidable moral failure, which I envisaged had a higher learning potential than authentic case stories used in regular teaching.
In order to justify this turn theoretically and test its didactic impact we developed this project on moral residue which spans moral philosophy, moral psychology, moral learning and medical ethics. It defends and further develops a minority position in moral philosophy that ought does not always imply can, i.e. that there exists situations of moral failure and associated moral emotions of anguish and regret moral agents might experience when faced with requirements they are unable to meet. This kind of distress experience or moral residue might arise from a failure that is inescapable due to a moral dilemma, or from a failure that is unavoidable due to normative ignorance or from a failure caused by impermissible emotions. The health care context within which this study will be carried out is replete with such situations, not the least during the present pandemic.
Objectives
The innovativeness of this project relates to four things:
- The conceptualization and phenomenological analysis of unavoidable moral failure and moral residue.
- The development of a typology of moral residue.
- The development of a validated measure of moral residue awareness and, thereby, moral learning.
- The implementation of a program of transformative reading in medical ethics using fictional representations of unavoidable moral failure.
Outcomes
Solbakk, J.H. (2021). Bio(po)ethics – didactic inspirations In: C. Mounsey and M. Mant (Eds.). You've Got to Be Carefully Taught: Bioethics and Education. Routledge: 147-184.
Detailed description of project team
Jan Helge Solbakk
Jan Helge Solbakk is a medical doctor and theologian, and he holds a PhD in Ancient Greek Philosophy. Since 1996, he has been Professor of medical ethics at Center for Ethics, University of Oslo. Between 1996 and 2011, he was Adjunct Professor of medical ethics at the Center for International Health, University of Bergen. In 2007 and 2008, he was Head of the UNESCO Bioethics Programme, UNESCO Headquarters, Paris. His current research focus is on irresolvable moral conflicts and the nature of moral learning. Solbakk has coordinated and been involved in various international research and capacity building projects relating to bioethics teaching, research ethics and integrity in research, research biobanking, personalised medicine, nanomedicine, stem cell research and the ethics of organoid research.
Lisa Tessman
Lisa Tessman is a Professor of Philosophy at Binghamton University in New York. She has published in ethics, moral psychology, feminist philosophy, and related areas. Her work focuses on how real human beings experience morality, especially under difficult conditions. Her most recent book is called When Doing the Right Thing Is Impossible; it is aimed at a general audience and can be read by people with no background in philosophy. The book focuses on those terrible situations in which no matter what you do, you’ll commit some moral wrongdoing. Her previous books include: Moral Failure: On the Impossible Demands of Morality (2015) and Burdened Virtues: Virtue Ethics for Liberatory Struggles (2005).
Cullin Brown
Cullin Brown is a PhD candidate in Philosophy at Binghamton University. His dissertation is on fitting affective attitudes and how they structure our personal lives and interpersonal practices (Consider: How should we think about the "Oh that is so terrible!" laugh we often have in response to morally problematic jokes? What values are at stake?). Cullin has taught and TAed courses in normative ethics, applied ethics, social and political philosophy, and logic. He and his wife have three dogs and currently spend most of their free time fixing up the old house they purchased and live in.
Mariette van den Hoven
Mariette van den Hoven is a professor in medical philosophy and medical ethics at Amsterdam UMC. She has built expertise in areas of public health ethics, professional ethics, research integrity and ethics educational research. She chairs the Netherlands Research Integrity Network, is member of the Integrity committee at the Free University and a member of the ethics review board.
Bert Molewijk
Bert Molewijk (1966; RN not practicing, MA, PhD) is full professor of Clinical Ethics Support and Quality of Care both at a) the Department of Ethics, Law & Humanities (ERH) at Amsterdam University Medical Centres (A UMC), and b) the Centre of Medical Ethics, University of Oslo, Norway. In Amsterdam, he is head of the section Ethics Support & Research Integrity. His main interest is in a) developing and co-creating innovative ways for integrative ethics support, and b) monitoring and fostering the contribution of ethics support to quality of care, team cooperation and moral competence, and c) methods in empirical ethics research. He is co-founder and coordinator of the European Clinical Ethics Network (ECEN; since 2005) and the Dutch Network for Ethics Support (NEON; since 2014). He is also General Secretary within the executive board of the European Association of Centres for Medical Ethics (www.EACMEweb.com).
Frank Hakemulder
Frank Hakemulder is Associate Professor at Liberal Arts and Sciences, Utrecht University, and full Professor at the Reading Center (University of Stavanger) with a background in literary theory. He is specialized in the psychology of literature, with a focus on the way reading may affect attitudes toward outgroup and moral self-concept. He has supervised various research projects on the experience of being absorbed in fictional worlds, and on how such experiences affect social perception and self-concepts. At the Reading Center he and his colleagues concentrate on the nature of deep reading and its relation to deep learning and readers’ mental well-being.
Bryan Doerries
Bryan Doerries is a New York-based writer, director, and translator who currently serves as Artistic Director of Theater of War Productions, a company that presents dramatic readings of seminal plays and texts to frame community conversations about pressing issues of public health and social justice. His books include The Theater of War: What Ancient Greek Tragedies Can Teach Us Today, The Odyssey of Sergeant Jack Brennan, All That You’ve Seen Here is God, and Oedipus Trilogy. For more information about his work, please visit: www.theaterofwar.com
Olivia Fialho
Olivia Fialho is Senior Researcher at the Huygens Institute (KNAW, Royal Netherlands Academy of Arts and Sciences) and Assistant Professor in Comparative Literature at Utrecht University. She has published in empirical, cognitive, and computational literary studies, and in literature education, including Scientific Approaches to Literature in Learning Environments (2016) and Transformative Reading (in press). In her work, she seeks insights from interdisciplinary domains to study the personal and social impact of reading and promote its benefits to people’s lives. She is the creator of Transformative Reading as an evidence-based program of literature teaching that impacts readers’ cognitive and emotional capacities, such as reflection on self and others, empathy, compassion, moral understanding, and motivation to read literature, among other benefits. The program is applied in education (primary, secondary, higher) and business (leadership). Her work at MORE entails adapting Transformative Reading to medical ethics. She is Associate Researcher in LCE (Literature, Cognition and Emotions), University of Oslo, and coordinates the IGEL coalition group Openess, Intensive Reflection and Self-Altering Literary Reading.
Janine de Snoo
Janine de Snoo is Assistant Professor on Clinical Ethics Support (CES) at Amsterdam UMC. Her research focuses on developing innovative methods for CES and evaluating CES services such as Moral Case Deliberation (MCD). She defended her PhD thesis Cum Laude on Outcomes of Moral Case Deliberation – Using, testing and developing the Euro-MCD Instrument to evaluate Clinical Ethics Support, in which various quantitative and qualitative research methods were combined. Furthermore, she has worked and is working on several projects aiming to develop practice-oriented support tools for healthcare professionals dealing with ethical dilemmas in everyday clinical practice. She currently is a member of the ethics review board within Amsterdam UMC. As a teacher, she is also involved in (coordinating) various courses on medical ethics education.
Nikoletta Alexandri
Nikoletta Alexandri is a Postdoctoral Researcher at the Huygens Institute (KNAW, Royal Netherlands Academy of Arts and Sciences) with a background in linguistics and media psychology. She completed her PhD at Lancaster University (UK), where she specialised in the psychological effects of literary reading and the use of experimental designs. Her thesis focused on the effects of fiction and non-fiction reading and how different reading media (e-readers, tablets, audiobooks, and print books) affect readers’ empathy, absorption, and narrative comprehension.
Financing
ERC advanced grant (2,455 million EURO).
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This project has received funding from the European Research Council (ERC) under the European Union’s Horizon Europe Framework Programme (HORIZON) Grant agreement No. 101054147. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Research Council Executive Agency. Neither the European Union nor the granting authority can be held responsible for them.
Cooperation
Amsterdam University Medical Center, VUMC.
The Royal Netherlands Academy of Arts and Sciences, KNAW.
Utrecht University.
Project start and finish
September 1. 2022 to August 31. 2027.