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PubMed1995

Sex role orientation and its relationship to the development of identity and moral thought.

This paper examined the links among sex role orientation, ego identity development and moral reasoning. 76 female and 58 male students were assessed on Bem's sex role inventory, ego identity, care-based and justice-based moral thought. For women, identity was negatively related to femininity and positively related to androgyny. Also, high levels of care-based moral reasoning, i.e., a balanced concern for the welfare of self and others, was related to androgyny for women. There were no significant findings for men. No significant relationships were found between sex role orientation and justice-based moral reasoning. Thus, the results suggested that for women in particular, relinquishing the stereotyped sex role definition and becoming more androgynous is important for their ego identity as well as care-based moral development.

Adolescent↗
PubMed1996

Euthanasia and persistent vegetative state individuals: the role and moral status of autonomy.

This paper offers a philosophical consideration and evaluation of several different criteria of moral standing, and discusses their implications for persistent vegetative state (PVS) individuals who were once competent. It is argued that the only criterion PVS individuals meet is that of being human, which is not the best test of moral standing. Accordingly it is, in principle, morally acceptable to perform passive or active euthanasia on PVS individuals or to use their bodies for research or for organ harvest. Nevertheless, the autonomous choices made by the persons the PVS individuals used to be can still impose moral obligations. Indeed, it is argued that the capacity for autonomy is a particularly appealing criterion of moral standing, and that the implications of this standard for PVS individuals confirm that appeal.

Advance Directive Adherence↗
PubMed1978

Delinquency and the development of moral reasoning.

A sample of 34 incarcerated male delinquents aged 16-17 and a matched group of controls were compared on self-report measures of delinquency, on Rest's (1975) Defining Issues Test (DIT) of moral reasoning, and on measures of logical operational ability. The mean levels of self-reported delinquency of the incarcerated group were substantially higher than those of the controls. There was no significant difference between the groups in logical operational ability but the mean P score (index of mature moral reasoning) was significantly higher in the control group. However, no relationship was found between moral reasoning and levels of self-reported delinquency. It was concluded that degree and seriousness of involvement of delinquency is unrelated to immaturity of moral reasoning and that the utility of the cognitive developmental approach to moral socialization may therefore be more restricted than has previously been claimed.

Adolescent↗
PubMed2002

Morale among general practitioners: qualitative study exploring relations between partnership arrangements, personal style, and workload.

OBJECTIVES: To explore general practitioners' experiences of wellbeing and distress at work, to identify their perceptions of the causes of and solutions to distress, and to draw out implications for improving morale in general practice. DESIGN: Three stage qualitative study consisting of one to one unstructured interviews, one to one guided interviews, and focus groups. SETTING: Fife, Lothian, and the Borders, South East Scotland. PARTICIPANTS: 63 general practitioner principals. RESULTS: Morale of general practitioners was explained by the complex interrelations between factors. Three key factors were identified: workload, personal style, and practice arrangements. Workload was commonly identified as a cause of low morale, but partnership arrangements were also a key mediating variable between increasing workload and external changes in general practice on the one hand and individual responses to these changes on the other. Integrated interventions at personal, partnership, and practice levels were seen to make considerable contributions to improving morale. Effective partnerships helped individuals to manage workload, but increasing workload was also seen to take away time and opportunities for practices to manage change and to build supportive and effective working environments. CONCLUSIONS: Solutions to the problem of low morale need integrated initiatives at individual, partnership, practice, and policy levels. Improving partnership arrangements is a key intervention, and rigorous action research is needed to evaluate different approaches.

Attitude of Health Personnel↗
PubMed2000

Emotion, regulation, and moral development.

Research and theory on the role of emotion and regulation in morality have received considerable attention in the last decade. Much relevant work has concerned the role of moral emotions in moral behavior. Research on differences between embarrassment, guilt, and shame and their relations to moral behavior is reviewed, as is research on the association of these emotions with negative emotionality and regulation. Recent issues concerning the role of such empathy-related responses as sympathy and personal distress to prosocial and antisocial behavior are discussed, as is the relation of empathy-related responding to situational and dispositional emotionality and regulation. The development and socialization of guilt, shame, and empathy also are discussed briefly. In addition, the role of nonmoral emotions (e.g. anger and sadness), including moods and dispositional differences in negative emotionality and its regulation, in morally relevant behavior, is reviewed.

Emotions↗
PubMed2002

Criminality and moral dysfunctions: neurological, biochemical, and genetic dimensions.

In this article, the author attempts to demonstrate a relationship between neurobiological dysfunctions and/or genetically determined deviant behavior and personality traits as well as moral abnormalities. Data from neuroscience show that a number of neurological dysfunctions are linked to cognitive and emotional disturbances. Cognitive and emotional abnormalities, in turn, are frequently related to moral dysfunctions. Moreover, neurological disorders can produce dramatic psychological and social problems, personality changes, and behavioral problems in patients. Those mental, emotional, and psychosocial problems and related moral dysfunctions are frequently linked to violence and/or criminal behavior. Genetic research found evidence of inheritability of antisocial traits, which interfere with moral development and activities. This information has consequences for any assessment and disposition within the legal system. More research on the interrelationship between neuro(bio)logical, genetic, emotional, and mental aspects of moral dysfunctions is needed for the development of adequate treatment, prevention, and intervention programs.

Affect↗
PubMed2000

Moral sensitivity: some differences between nurses and physicians.

We report the results of an investigation of nurses' and physicians' sensitivity to ethical dimensions of clinical practice. The sample consisted of 113 physicians working in general medical settings, 665 psychiatrists, 150 nurses working in general medical settings, and 145 nurses working in psychiatry. The instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting Likert-type questionnaire consisting of 30 assumptions related to moral sensitivity in health care practice. Each of these assumptions was categorized into a theoretical dimension of moral sensitivity: relational orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict, and following the rules. Significant differences in responses were found between health care professionals from general medical settings and those working in psychiatry. The former agreed to a greater extent with the assumptions in the categories 'meaning' and 'autonomy' and to a lesser degree with the categories 'benevolence' and 'conflict'. Moreover, those from the psychiatric sector agreed to a greater extent to the use of coercion if necessary. Significant differences were also found for some of the MSQ categories, between physicians and nurses, and between males and females.

Ethics, Medical↗
PubMed1999

Moral problems among Dutch nurses: a survey.

This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally the most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice.

Adult↗
PubMed2001

Moral problems in palliative care journals.

With the growth of palliative care services, interest in moral issues also seems to be growing. However, we need to know which moral issues are specific to palliative care. The first step in answering this is to consider the moral concerns raised and discussed by the palliative care community itself. This article presents a bibliographical analysis of moral problems, first by selecting the problems identified as moral problems in the leading palliative care journals, and then by classifying these into different types.

Bibliometrics↗
PubMed2002

Beyond the boundary between science and values: re-evaluating the moral dimension of the nurse's role in cot death prevention.

This article combines a philosophical critique of the idea that public health nurses are primary technicians who neutrally hand over scientifically established facts on risks to the public and an empirical analysis of the actual work of public health nurses. It is argued that the relationship between facts and values in public health is complex and that, despite the introduction of several scientifically-based standards and guidelines, public health nurses are not technicians. They do moral work and experience ethical dilemmas. To get a grip on the specific character of this moral work, we distance ourselves from the idea that there are ethical dilemmas in public health nursing for which we can provide general ethical rules and principles. Instead we suggest a contextual ethical approach, in which several different kinds of consideration may be important. To illustrate this, we analysed 15 in-depth interviews with nurses involved in the prevention of cot deaths in the Netherlands. It is shown that these nurses do not neutrally pass on the epidemiological facts on the risks of prone sleeping, warm bed-clothes and passive smoking, but they are the moral architects of this preventive practice. It is also shown that this moral work and the ethical dilemmas they experience cannot be characterized in terms of general ethical rules and principles. It becomes clear that the moral work of nurses differs according to the three main risks at stake: the balance between virtue, risk taking and responsibility depends on the specific context.

Adult↗
PubMed2002

Nurse moral distress: a proposed theory and research agenda.

As professionals, nurses are engaged in a moral endeavour, and thus confront many challenges in making the right decision and taking the right action. When nurses cannot do what they think is right, they experience moral distress that leaves a moral residue. This article proposes a theory of moral distress and a research agenda to develop a better understanding of moral distress, how to prevent it, and, when it cannot be prevented, how to manage it.

Adaptation, Psychological↗
PubMed2004

Caring about--caring for: moral obligations and work responsibilities in intensive care nursing.

The aim of this study was to analyse experiences of moral concerns in intensive care nursing. The theoretical perspective of the study is based on relational ethics, also referred to as ethics of care. The participants were 36 intensive care nurses from 10 general, neonatal and thoracic intensive care units. The structural characteristics of the units were similar: a high working pace, advanced technology, budget restrictions, recent reorganization, and shortage of experienced nurses. The data consisted of the participants' examples of ethical situations they had experienced in their intensive care unit. A qualitative content analysis identified five themes: believing in a good death; knowing the course of events; feelings of distress; reasoning about physicians' 'doings' and tensions in expressing moral awareness. A main theme was formulated as caring about--caring for: moral obligations and work responsibilities. Moral obligations and work responsibilities are assumed to be complementary dimensions in nursing, yet they were found not to be in balance for intensive care nurses. In conclusion there is a need to support nurses in difficult intensive care situations, for example, by mentoring, as a step towards developing moral action knowledge in the context of intensive care nursing.

Empathy↗
PubMed2000

Development of the school organisational health questionnaire: a measure for assessing teacher morale and school organisational climate.

BACKGROUND: A growing body of empirical evidence suggests that organisational factors are more important than classroom specific issues in determining teacher morale. Accordingly, it is necessary to have available measures that accurately assess morale, as well as the organisational factors that are likely to underpin the experience of morale. AIM: Three studies were conducted with the aim of developing a psychometrically sound questionnaire that could be used to assess teacher morale and various dimensions of school organisational climate. SAMPLE: A total of 1,520 teachers from 18 primary and 26 secondary schools in the Australian state of Victoria agreed to participate in three separate studies (N = 615, 342 and 563 in Studies 1, 2 and 3, respectively) that were used to develop the questionnaire. The demographic profile of the teachers was similar to that found in the Department as a whole. METHOD: All teaching staff in the participating schools were asked to complete a self-report questionnaire as part of the evaluation of an organisational development programme. RESULTS: A series of exploratory and confirmatory factor analyses were used to establish the questionnaire's factor structure, and correlation analyses were used to examine the questionnaire's convergent and discriminant validity. CONCLUSIONS: The three studies resulted in the 54-item School Organisational Health Questionnaire that measures teacher morale and 11 separate dimensions of school organisational climate: appraisal and recognition, curriculum coordination, effective discipline policy, excessive work demands, goal congruence, participative decision-making, professional growth, professional interaction, role clarity, student orientation, and supportive leadership.

Adolescent↗
PubMed2004

Moral distress: the state of the science.

Moral distress, a complex human experience, has lacked a clear, complete definition. Intuitively, clinicians know that moral distress might be occurring for patients with increasing frequency due to technological advances that alter the natural order of life and death. Yet clinicians have not been able to evaluate the presence or extent of moral distress. To date, moral distress has been investigated mainly as an occupational issue using Jameton's (1984) definition, which has been problematic for several reasons. Without an adequate definition, moral distress can be unrecognized, yet have a silent, clinically significant impact on health. The literature is discussed from several perspectives to show the current state of the science in this topical area, and its potential future.

Ethical Analysis↗
PubMed1992

Toward a political and moral economy of aging: an alternative perspective.

A conceptual framework for empowerment of the elderly is proposed, using variations on Gramsci's hegemony and Thompson's moral economy to complement recent political economic and social psychological theories. The political economy and social psychology of aging highlight structural constraints and actors' reactions without articulating a model for empowerment. Gramsci's idea of hegemony as new moral and philosophical leadership calls for principles of social and economic organization deserving assent because they maximize people's chances for a decent life at all ages. Hegemony, as normalizing dominance, reveals ways in which the elderly may be disempowered as well as possibilities for intervention. Underlying diverse forms of hegemony are economic arrangements and an array of cultural norms. In contrast to Thompson, the authors argue that norms implicit in moral economy vary with changes in social context. In the process, two ideal types of moral economy are elaborated, grounded in exchange value and use value, respectively. Empowerment may be found through a moral economy grounded in use value appropriate to advanced industrial society that is consonant with Gramsci's new hegemony. Implications for health and income maintenance policies are explored.

Aged↗
PubMed1992

Moral development and behavior.

The study of moral development as well as the relation of moral development and behavior has been of great interest to many over the past half a century. While some studies have shown no association between one's moral development and behavior, some evidence indicates level of moral reasoning influences behavior. Over 16 selected studies postconventional principles of justice are likely to be more prosocial and law-abiding than those appropriate at the lower stages of moral development.

Humans↗
PubMed2006

Moral reasoning and personality traits.

Moral reasoning should not be clearly associated with measures of personality traits. Although this assumption pervades the moral reasoning literature, it may not always be true. This paper provides evidence that moral reasoning, as assessed with P scores of the Defining Issues Test, is indeed positively associated with five traits from the California Psychological Inventory: Achievement via Independence, Intellectual Efficiency, Tolerance, Responsibility, and Capacity for Status. Such relationships make conceptual sense, shed light on the meaning and implications of moral reasoning, call into question prevailing assumptions in the literature, and may encourage investigators to broaden the types of research questions asked in the context of moral reasoning.

Achievement↗
PubMedDate not supplied

Relocation appraisal, functional independence, morale, and health of nursing home residents.

Relocation to a nursing home can be stressful and may result in mental and physical illness. Appraisal, or the meaning assigned to relocation, can influence relocation outcome. This study examined the relationships between appraisal of relocation and 30 nursing home residents' psychological and physical health, morale, functional independence, and demographic and situational factors, including age, gender, income, education, prior residence, participation in the decision to relocate, and preparation for the move. Positive, benign, and challenge appraisals were related to higher morale and functional independence. Threat appraisal was related to poorer psychological health and lower morale. Harm-loss appraisal was associated with lower morale and lower functional independence. Preparation for the move was related to higher positive appraisal, higher morale, functional independence, and lower harm-loss scores. Implications include the need to assess people's appraisal of relocation so as to plan strategies that prevent relocation stress.

Activities of Daily Living↗