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People can be uncertain in their moral judgments. Philosophers have argued that such uncertainty can either refer to the underlying empirical facts (empirical uncertainty) or to the normative evaluation of these facts itself (normative uncertainty). Psychological investigations of this distinction, however, are rare. In this paper, we combined factor-analytical and experimental approaches to show that empirical and normative uncertainty describe two related but different psychological states. In Study 1, we asked N = 265 participants to describe a case of moral uncertainty and to rate different aspects of their uncertainty about this case. Across this wide range of moral scenarios, our items loaded onto three reliable factors: lack of information, unclear consequences, and normative uncertainty. In Study 2, we confirmed this factor structure using predefined stimulus material. N = 402 participants each rated eight scenarios that systematically varied in their degree of uncertainty regarding the consequences of the described actions and in the value conflict that was inherent to them. The empirical uncertainty factors were mainly affected by the introduction of uncertainty regarding consequences, and the normative uncertainty factor was mainly affected by the introduction of value conflict. Our studies provide evidence that the distinction between empirical and normative uncertainty accurately describes a psychological reality. We discuss the relevance of our findings for research on moral judgments and decision-making, and folk metaethics.

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We are sometimes unsure of the moral status of our relationships with other entities. Recent case studies in this uncertainty include our relationships with artificial agents (robots, assistant AI, etc.), animals, and patients with "locked-in" syndrome. Do these entities have basic moral standing? Could they count as true friends or lovers? What should we do when we do not know the answer to these questions? An influential line of reasoning suggests that, in such cases of moral uncertainty, we need meta-moral decision rules that allow us to either minimize the risks of moral wrongdoing or improve the choice-worthiness of our actions. One particular argument adopted in this literature is the "risk asymmetry argument," which claims that the risks associated with accepting or rejecting some moral facts may be sufficiently asymmetrical as to warrant favoring a particular practical resolution of this uncertainty. Focusing on the case study of artificial beings, this article argues that this is best understood as an ethical-epistemic challenge. The article argues that taking potential risk asymmetries seriously can help resolve disputes about the status of human-AI relationships, at least in practical terms (philosophical debates will, no doubt, continue); however, the resolution depends on a proper, empirically grounded assessment of the risks involved. Being skeptical about basic moral status, but more open to the possibility of meaningful relationships with such entities, may be the most sensible approach to take.

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BACKGROUND: Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses' experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. RESEARCH AIM: To analyze frontline U.S. nurses' experiences of ethics during the COVID-19 pandemic. RESEARCH DESIGN: Qualitative analysis using a directed content methodology. PARTICIPANTS AND RESEARCH CONTEXT: The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. ETHICAL CONSIDERATIONS: Participant privacy and data confidentiality were addressed. FINDINGS: Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. DISCUSSION: This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. CONCLUSIONS: Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available.

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This study explores the perceptions of Norwegian nurses who have received assisted dying requests from terminally ill patients. Assisted dying is illegal in Norway, while in some countries, it is an option. Nurses caring for terminally ill patients may experience ethical challenges by receiving requests for euthanasia and assisted suicide. We applied a qualitative research design with a phenomenological hermeneutic approach using open individual interviews. A total of 15 registered nurses employed in pulmonary and oncology wards of three university hospitals and home care in one municipality were recruited. Four themes emerged from the analysis: (1) unprepared for the request; (2) meeting direct, indirect, and nonverbal requests; (3) working in a gray zone, and (4) feeling alone and powerless. The study found that nurses were unsure how to handle such requests due to professional uncertainty about assisted dying. Working in an environment where the topic is taboo made nurses morally uncertain, and some perceived this as moral distress. The hospital chaplain played a significant role in providing support to these nurses.

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BACKGROUND: Most writing about uncertainty in healthcare has addressed empirical uncertainty - that is, resulting from insufficient or conflicting facts. OBJECTIVE: To consider moral uncertainty by exploring how different theories apply to a single clinical case. METHOD: In this philosophical reflection, I briefly acknowledge empirical uncertainty before introducing and exploring the topic of moral uncertainty - defined as the question of what to do when we do not know what (morally) to do-using a case study of my own mother's deterioration and death from Covid-19. RESULTS: I identify and apply a number of philosophical theories relevant to managing moral uncertainty, including utilitarianism, deontology, practical rationality and feminist philosophy. CONCLUSION: Different moral theories lead to different conclusions about the best course of action in situations of moral uncertainty. PRACTICE IMPLICATIONS: Detailed analysis and close reading of a single case can provide insights into how to act in morally complex situations, but learning is in the form of enriched understanding, not formulaic rules.

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Our present moral traits are unable to provide the level of large-scale co-operation necessary to deal with risks such as nuclear proliferation, drastic climate change and pandemics. In order to survive in an environment with powerful and easily available technologies, some authors claim that we need to improve our moral traits with moral enhancement. But this is prone to produce paradoxical effects, be self-reinforcing and harm personal identity. The risks of moral enhancement require the use of a safety framework; such a framework should guarantee practical robustness to moral uncertainty, empirical adequacy, correct balance between dispositions, preservation of identity, and be sensitive to practical considerations such as emergent social effects. A virtue theory can meet all these desiderata. Possible frameworks incorporate them to variable degrees. The social value orientations framework is one of the most promising candidates.

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Interprofessional (IP) education has emerged globally as a means of improving overall healthcare quality, and to increase healthcare provider understanding of other roles. However, in situations of moral uncertainly, there are not clear procedures to address IP role interactions when tension and conflict emerge. This study reports secondary analysis findings from data in a large study related to moral distress in IP ethics consultations and collaborations. A basic qualitative, exploratory approach was utilized for data analysis with overtones of grounded theory. Eleven IP participants representing five disciplines comprised the sample. A model of IP role interaction was constructed from themes which were revealed to identify distinct facilitating actions and barriers as components of IP interactions serving to balance ethical decision making in the context of patient care. Specific role boundaries of the professions identified uncertainty as they interacted with multiple healthcare roles in patient care dilemmas.

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This article presents ethnographic data on the use of prescription stimulants for enhancement purposes by university students in New York City. The study shows that students find stimulants a helpful tool in preventing procrastination, particularly in relation to feeling disinterested, overloaded, or insecure. Using stimulants, students seek pleasure in the study situation, for example, to get rid of unpleasant states of mind or intensify an already existing excitement. The article illustrates the notion that enhancement strategies do not only concern productivity in the quantitative sense of bettering results, performances, and opportunities. Students also measure their own success in terms of the qualitative experience of working hard. The article further argues that taking an ethnographic approach facilitates the study of norms in the making, as students experience moral uncertainty-not because they improve study skills and results-but because they enhance the study experience, making work fun. The article thereby seeks to nuance simplistic neoliberal ideas of personhood.

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En el presente artículo de reflexión se estudian algunos de los aspectos filosóficos relacionados con la antropología cultural y la Bioética, en la así llamada contemporánea "Sociedad del Conocimiento". La incertidumbre moral, que lo es también cultural, es factor dominante en el horizonte de las tecnociencias y se constituye en instancia necesaria de reflexión bioética. Cuando se trata de dubitación moral, ocasionada por la amenaza severa de las biotecnociencias a la viabilidad de la vida humana y de todo tipo de vida sobre el planeta Tierra, surge la Bioética como interdisciplina que reclama cordura sapiencial a favor de una nueva cultura de la vida de cara al futuro, para lo cual es necesario articular armónica y proactivamente el desarrollo de las Tecnociencias con las Humanidades...

Some philosophical aspects related to Bioethics and Cultural Anthropology in the contemporaneous “Society of Knowledge” are studied in this essay. We have taken as a turning point for analysis, the incidence of biotechnologies sciences in the horizon of moral values which are invading today the entire physical and cultural living phenomenon. Moral uncertainty is the dominant factor in that horizon and it constitutes a necessary point of reflection. Bioethics rises as an interdisciplinary activity, which favors a kind of prudential wisdom in pursuit of a new life style that faces the future. In order to do this, it is necessary to articulate a new culture of life that would make it possible for the Sciences and the Humanities to exist in harmonY...

No presente artigo de reflexão são estudados alguns dos aspectos filosóficos relacionados com a antropologia cultural e a Bioética, na assim chamada “Sociedade do Conhecimento” contemporânea. A incerteza moral, que também é cultural, é fator dominante no horizonte das tecnociências e constitui uma necessária instância de reflexão bioética. Quando se trata de dubitação moral, ocasionada pela grave ameaça das biotecnociências à viabilidade da vida humana e de todo tipo de vida sobre o planeta Terra, surge a Bioética como interdisciplina que reclama cordura sapiencial a favor de uma nova cultura da vida com vistas ao futuro, para o que é necessário articular de forma harmônica e produtiva o desenvolvimento das Tecnociências com as Humanas...

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