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PubMed2000

Temperament as a moderator of pathways to conscience in children: the contribution of electrodermal activity.

A longitudinal study (G. K. Kochanska, 1997) showed that temperamental fearfulness, assessed at toddler age via observational data and maternal ratings, moderated pathways to internalized conscience at age 4. For fearful children, maternal gentle discipline deemphasizing power predicted conscience development; for fearless children, attachment security predicted conscience development. Electrodermal reactivity assessed at age 4 on the same children was used as a physiological reflection of fearful temperament and was substituted for the earlier fearfulness measure to test the theoretical model. As expected, for electrodermally reactive children, maternal gentle discipline predicted conscience, whereas for nonreactive children, attachment security predicted conscience. The findings support the notions of (a) electrodermal reactivity at an early age as a correlate of temperament, (b) temperament as a moderator of socialization in early moral development, and (c) lovelessness in psychopathic individuals as an index of the failure of the alternative pathway (via attachment) to conscience in fearless children.

Arousal↗
PubMed2006

Impact of the Konstanz method of dilemma discussion on moral judgment in allied health students: a randomized controlled study.

The objective of the study was to determine the effect of the Konstanz method of moral dilemma discussion (KMDD) on moral judgment in allied health students. The study employed the Moral Judgment Test, translated from English into Thai and validated in 247 students, as an moral judgment instrument. The scale satisfied four validity criteria: preference hierarchy, quasi-simplex structure of stage preference, affective-cognitive parallelism, and positive correlation between education and moral competence score (C-index). Test-retest reliability at a 1-month interval was 0.90. To investigate the impact of the KMDD, 83 pharmacy technician and dental nursing students were asked to participate in the study. The subjects were randomly assigned into control (n = 41) or experimental (n = 42) groups. The experimental group participated in a 90-min KMDD once a week for 6 consecutive weeks. Students in the control group also met once a week for 6 weeks to discuss the topics not related to ethics. All subjects completed the Moral Judgment Test before and after the intervention and again 6 months later. Split-plot ANOVA of the C-indexes at the beginning revealed that the experimental and control groups were not different (20.57 +/- 13.45 and 24.98 +/- 16.12). However, the experimental group scored significantly higher than the control group did after the intervention (35.18 +/- 10.96 and 24.20 +/- 14.70) and 6 months later (33.00 +/- 11.02 and 23.67 +/- 14.35). The KMDD appears to be a practical and effective intervention for developing moral judgment in allied health students. The effect on moral judgment remains at least 6 months after the intervention.

Adolescent↗
PubMed1995

The Anne Frank Haven in an Israeli Kibbutz.

The Anne Frank Haven, founded in 1956, in the Israeli Kibbutz Sasa provides a unique educational program for coping with muticultural and integration problems. It is a holistic, regional junior and senior high school system within the holistic community of three kibbutzim. The Haven has been the subject of much research into "Moral Development," carried out by Wolins (1969, 1971), and mainly by Kohlberg (1971), his doctoral students Reimer and Snarey and other colleagues. In the seventies and eighties they used the Kibbutz example as a model for the "Just Community" approach. In the early nineties, an Israeli group evaluated the success of the program and its rationale, taking into consideration all the "educational factors" of the community, in the Haven, and in the kibbutzim around it. This article offers a comprehensive picture of the Kohlbergian moral-developmental research at the Anne Frank Haven, including all the relevant references and evaluations of the Haven as a part of the "Just Community" approach. It concludes with a suggestion for another approach--"Community Education" research in the same Haven--as an example of present and future studies in the area of "Moral" and "Values" education.

Acculturation↗
PubMed2000

Media and civic socialization of youth.

Research on the development of citizenship has been reinvigorated by considering adolescents as participants actively engaged in, and interacting with, family, peers, teachers, and the media. This contrasts with earlier top-down transmission models that saw adolescents as passive recipients of information from parents and teachers. Active citizenship is now seen as a largely indirect result of contextualized knowledge and cognitive skills learned from news media use, interpersonal communication, and active participation in school and community volunteer activities. The processes of active citizenship learning are an important part of the moral development of adolescents and young adults.

Adolescent↗
PubMed1989

[Development of a moral consciousness in medical schools].

In the conditions of developed socialism, changes in social consciousness are also reflected in one of its forms - the morals. The problems of moral education as an inseparable part of communist education is coming to the foreground. It plays its role in all the stages of the education system, having its unsubstitutable place also in the conditions of universities and technical colleges, the faculties of medicine not excluding. It is its task to form the personality of the student and graduate, to make them, among others, acquire the moral codex of a builder of communism (habits of moral behaviour in professional activities - medical ethics). Such crucial situations must be found that are of cardinal importance for the formation of the medical student's moral profile (transition from the secondary school to university, entering the clinic, meeting the patient, running health institutions, positive and negative influences in the health service). The student must live the moral situation, obtain the experience from moral acting on his own self and be an active participant in the events creating his moral qualities, primarily in collective conditions. We stress the necessity of engagement - mobilisation of students to all-round social activities, connection of the theoretical findings of marxist ethics with their particular problems and actual activities. A special accent is laid on the method of personal example, the moral example of the university teacher himself, in the first place his authority based on all the progressive components of his personality.(ABSTRACT TRUNCATED AT 250 WORDS)

Communism↗
PubMed1999

Ethics education and physician morality.

Medical ethics education remains an important venue of moral education. In spite of the intensity of these efforts, the desired outcomes of medical ethics education remain obscure, undefined and largely untested. In the first part of this study, the goals of medical ethics are operationalized along cognitive, behavioral and attitudinal dimensions. This includes a written moral judgment test, a survey of ethical confidence, competence and interest, attitudinal surveys of physician assisted suicide, and aggressive treatment of newborns and, finally, self-reported behavior about the frequency of pro-bono work and treatment of self-abusive patients. Medical ethics education is operationalized by the type, scope and intensity of ethics education throughout a physician's education and subsequent career. Data were collected by a questionnaire distributed to the staff of a large urban hospital in 1996 (n = 200, response rate = 41%). Causal models measure the effects of medical education. The results suggest that ethics education plays an important but limited role in the attainment of these cognitive, attitudinal and behavioral outcomes. While some outcomes such as moral development, and ethical confidence are unaffected by ethics education, other attitudinal and behavioral objectives, such as ethics interest and pro-bono work are positively associated with formal ethics training as well as with demographic variables such as religious observance and age. Ethics education does not function as an isolated factor but as part of a web of interrelated factors that influence educational outcomes. In addition, it is clear that ethics education resists quantitative analysis to some extent. Rather, it is sometimes viewed as a discipline that is studied for its own sake with the hope that it may contribute to one's all around character in a way that cannot be directly assessed. These implications are explored in the conclusion of the paper.

Adult↗
PubMed1992

The philosopher in the health care setting: objections and replies.

This article presents a series of objections against having philosophers in the health care setting and rebuttals to these objections. These objections occur often enough to deal with them as characteristic criticisms. The rebuttals outline and advocate the positive--yet limited--function of the philosopher's presence in health care.

Attitude of Health Personnel↗
PubMed1996

Accounting for context: future directions in bioethics theory and research.

Many physicians have found that the traditional approach to bioethics fails to account for important aspects of their moral experience in practice. New approaches to bioethics theory are challenging the traditional application of universal moral principles based in liberal moral theory. At the same time, a shift in both the goals and methods of bioethics education has accompanied its "coming of age" in the medical school curriculum. Taken together, these changes challenge both bioethics educators and theorists to come closer to the details and nuances of real clinical encounters. The emerging trend emphasizes the importance of context in bioethics education and in the moral theory and research undergirding it. This article introduces one research approach examining the practical life contexts of medical students' ethical experiences and learning. It calls for increased attention to research and theory in bioethics that more adequately accounts for the ways different contexts produce significant changes in meaning and understanding in medical encounters.

Bioethics↗
PubMed1995

Moral growth in medical students.

Although students bring to medical school a fairly well established value system, the potential for moral growth through the medical school environment and experience is substantial. The educational environment poses a succession of developmental and adaptive tasks to be accomplished. Several of these tasks are discussed her, tasks that are value-laden and involve, directly or indirectly, the interplay of ethical theory and practice. During the past quarter century, the two influences that have had the greatest impact on the moral growth and moral reasoning capacity of medical students have been the incorporation into the medical school curriculum of courses in medical humanities and the admission to medical school of an increasing number of female students. The female students have brought to medical school a level or dimension of moral reasoning (morality as care or responsibility for others) to augment the male students' focus on rights and justice considerations.

Attitude to Death↗
PubMed1995

Commentary: moral growth in medical students.

Knight has shown how the moral growth of medical students involves a spiritual journey. He may, however, present too sanguine a portrayal of the extent to which the medical education environment promotes this moral and spiritual growth. Medical school may indeed be more abusive than supportive. Admitting more women to medical school and teaching more humanities courses, while worthwhile, will not necessarily promote the goals that Knight appropriately advocates.

Bioethics↗
PubMed1992

Gender in bioethics: theory and practice -- an introduction.

Does the care perspective make a difference? Can it reach as far as we would like? It is the goal of this special issue on Gender in Bioethics: Theory and Practice to begin to address some of these important questions. In the first article, Virginia Sharpe provides a comprehensive and thoughtful analysis of how the orientations of justice and care are played out in medical ethical theory. In the second article, James Nelson argues that the more traditional approach in Bioethics to maternal-fetal conflicts is not useful, and that a care perspective is more appropriate. Thoughtful commentary on Nelson's article is provided by Rosemarie Tong. For readers new to the justice-care debate in moral theory, the following articles will provide an informative introduction. For those who are more familiar, it is hoped that you will be challenged by the extension of the debate to the practical issue of maternal-fetal conflicts.

Bioethics↗
PubMed1995

Evoking the moral imagination: using stories to teach ethics and professionalism to nursing, medical, and law students.

Four years ago, as colleagues in our university's law and medical schools, we designed and began offering a course for law, medical, and nursing students, studying professionalism and professional ethics by reading and discussing current and earlier images of nurses, doctors, and lawyers in literature. We wanted to make professional ethics, professional culture, and professional education the objects of study rather than simply the unreflective consequences of exposure to professional language, culture, and training. We wanted to do it in an interdisciplinary course where aspiring professionals could share their self-conceptions and their conceptions of each other, and we wanted to do it by using stories, our primary means for organizing experience and claiming meaning for it. This article tells the story of that experience: why we did it; how we did it; what we learned from doing it.

Curriculum↗
PubMed1996

The Nazi doctors and the medical community; honor or censure? The case of Hans Sewering.

During the Nazi era, most German physicians abrogated their responsibilities to individual patients, and instead chose to advocate the interests of an evil regime. In so doing, several fundamental bioethical principles were violated. Despite gross violations of individual rights, many physicians went on to have successful careers, and in many cases were honored. This paper will review the case of Hans Sewering, a participant in the Nazi euthanasia program who became the President-elect of the World Medical Association. The appropriate stance for the medical and scientific community toward those who violate human rights and ignore fundamental ethical principles of the healing professions will be considered.

Ethics, Medical↗