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PubMed1989

Assess not assume--measuring the morale of cognitively impaired elderly.

The morale of cognitively impaired elderly has not been systematically studied as this group has been excluded in most studies of well-being. This study showed that most cognitively impaired persons who retain verbal skills were able to respond to a verbally administered assessment using the Philadelphia Geriatric Center Morale Scale. Support for the reliability and validity of measurement of morale in cognitively impaired elderly using the Philadelphia Geriatric Center Morale Scale was reported. Ratings of the morale of cognitively impaired persons by family members were significantly associated with self-report by elders, but tended to be lower.

Aged↗
PubMed2000

The moral justification scale: reliability and validity of a new measure of care and justice orientations.

Research increasingly suggests that there are limitations to Kohlberg's theory of moral development. Gilligan in particular has observed that Kohlberg's theory considers abstract principled reasoning as the highest level of moral judgment, and penalizes those who focus on the interpersonal ramifications of a moral decision. Gilligan calls these justice and care orientations. The present paper describes the development of the Moral Justification Scale, an objective measure of the two orientations. The scale consists of six vignettes, of which two are justice oriented, two are care oriented, and two are mixed, incorporating both orientations. Construct validity was evaluated by expert judges and, overall, was high. Cronbach's alpha was .75 for the Care subscale and .64 for the Justice subscale, indicating adequate internal consistency. Split-half reliabilities were as follows: Care, r = .72, p < .01, and Justice, r = .60, p < .05. Regarding test-retest reliability (approximately two weeks), r = .61, p < .05, for Care; r = .69, p < .05, for Justice. Neither subscale correlated significantly with the Marlowe-Crowne Social Desirability Scale. Thus, the Moral Justification Scale shows promise as an easily administered, objectively scored measure of Gilligan's constructs of care and justice.

Acculturation↗
PubMedDate not supplied

The withholding and withdrawal of medical treatment: moral principles and the law #.

In most hospitals in Puerto Rico the dying process of terminally ill patients is inappropriately prolonged. And this occurs often without the patient's consent and in violation of basic ethical principles. Three erroneous beliefs are prevalent: 1--That withdrawing life support therapy is morally or legally different from not starting it. 2--That there is a moral and legal difference between appropriate acts and appropriate omissions. 3--That good medical practice is determined by the courts instead of the medical profession. Institutional policies are not in harmony with contemporary medical ethics. To avoid possible legal entanglements medical institutions permit their faculties to prolong the suffering of patients in violation of two basic moral principles: nonmaleficence and respect for autonomy. An illustrative case provides a philosopher and a moral theologian the opportunity to analyze the applicable moral principles. A professor of jurisprudence reviews statutes evolved at the State and Federal level that support the rights of patients and their families to refuse unwanted treatments. Medical faculties must ensure that institutional policies do not violate their professional ethics. The medical profession and the citizenry at large should lobby for the passage of statutes in Puerto Rico which clearly validate the necessary harmony between medical ethics and the law.

Aged↗
PubMed2000

Children's rights: reasoning and their level of moral development: an empirical investigation.

Children's reasoning about their rights is largely determined by their level of development. Since rights-reasoning concerns essentially moral issues, the best foundation to contextualise the developmental process mentioned would be to consider a moral-developmental approach. In this regard Kohlberg's theory of moral development has been found to be the primary theory that researchers have built on. The article focuses on an empirical investigation done with 312 South African children of varying ages, cultures and language groups into their level of moral-development and rights-reasoning. The two questionnaires used were Kohlberg's Standard Issue Score (Form B) and Melton's Children's Rights Interview. The most important findings made were that Kohlberg's theory of universalizability and unvariant order of sequence along with its applicability to gender and culture was confirmed for this South African study. Furthermore an important correlation between rights-reasoning development and level of moral ethical development was made which implies that an interdependent relationship exists between them.

Adolescent↗
PubMed2001

Religion and the morality of mentality.

Christian doctrine considers mental states important in judging a person's moral status, whereas Jewish doctrine considers them less important. The authors provide evidence from 4 studies that American Jews and Protestants differ in the moral import they attribute to mental states (honoring one's parents, thinking about having a sexual affair, and thinking about harming an animal). Although Protestants and Jews rated the moral status of the actions equally. Protestants rated a target person with inappropriate mental states more negatively than did Jews. These differences in moral judgment were partially mediated by Protestants' beliefs that mental states are controllable and likely to lead to action and were strongly related to agreement with general statements claiming that thoughts are morally relevant. These religious differences were not related to differences in collectivistic (interdependent) and individualistic (independent) tendencies.

Adult↗
PubMed1975

Moral and cognitive development in retarded and nonretarded children.

Subjects were 30 cultural-familially retarded and 30 nonretarded children matched for MA within 3 MA levels. The subjects were administered measures of moral judgement and cognitive operations hypothesized by Kohlberg to constitute necessary but not sufficient conditions for attainment of specific moral stages. Moral and cognitive performance improved with MA, but there were no differences between the MA-matched retarded and nonretarded children. Moral judgement related more strongly to MA then to any of the specific cognitive operations tested. The findings failed to support Kohlberg and Gilligan's (1971) hypothesis that the moral judgment of older individuals should be more advanced than that of younger individuals matched for cognitive level, but they were in accord with Zigler's (1969) "developmental" concept of cultural-familial retardation.

Association↗
PubMed2002

Moral hypocrisy: addressing some alternatives.

Two studies addressed alternative explanations for 3 pieces of evidence supporting the existence of moral hypocrisy. In Study 1, no support was found for the idea that low salience of social standards accounts for falsifying the result of a coin flip to assign oneself a more desirable task. In Study 2, no support was found for the idea that responses of those who honestly win the flip account for the higher ratings of morality of their action by participants who assign themselves the more desirable task after flipping the coin. Also, no support was found for the idea that responses of those who honestly win the flip account for the inability of personal moral responsibility measures to predict moral action. Instead, results of both studies provided additional evidence of moral hypocrisy.

Decision Making↗
PubMed1976

Moral reasoning from the perspective of others.

A questionnaire study was conducted to examine the ability of adolescents and college students to deliberate about moral dilemmas from social perspectives (roles) other than their own and to display different levels of moral judgment in these different perspectives. 30 subjects at each of grades 9, 10, 12, and college were administered a moral reasoning questionnaire and asked to respond 3 times--once for each of the social roles of self, average policeman, and average philosopher. Results showed that across roles and with increasing age there was an increase in individuals' tendencies to choose principled moral issues to resolve dilemmas. More important, there was an increase with age in differentiation among social roles--with the college students evidencing the greatest differences in the level of moral issues chosen as a function of social role.

Adolescent↗
PubMed2002

Moral distress--the role of ethics consultation in the NICU.

Moral distress is a common occurrence for individuals involved in the care of critically ill infants. The ability to reason through difficult situations is often complicated by intensely emotional circumstances. Ethics consultation in the Neonatal Intensive Care Unit is a useful tool for caregivers and families who face moral problems. Understanding the responsibility of caregivers and parents to act as independent moral agents is an essential element in reducing moral distress and working collaboratively to resolve moral problems.

Caregivers↗
PubMed2002

Virtue, foible, and practice--medicine's arduous moral triad.

Moral distress is often discussed as a response to the moral dilemmas that professional and other caregivers encounter in their effort to balance competing moral principles, or to provide care in difficult cases, to difficult patients, in spite of difficult institutional requirements or policy. In this essay, a reforming ER clinician and teaching physician, offers a personal approach to moral distress. Assuming that a clinician's own foibles may sometimes contribute to another's distress, and that attempting to rationalize or subvert these foibles causes moral fatigue, he offers personal guidelines for healthcare providers--four strategies that less-than-perfect practitioners may use while striving to attain the ideal of the competent, compassionate, altruistic, calm, and wise clinician.

Emergency Medicine↗
PubMed2002

Moral fatigue--a nursing perspective.

It is perhaps inevitable that a phenomenon called moral fatigue would be labeled, described, and applied to nurses, whose working environment has more than its share of moral conflicts. When professionals' duties to patients and their families--duties that are caught up in uncertainty and fast-paced institutional and cultural change--are made to seem irrelevant to the patients' real needs, the resulting discomfort of professionals is generally called moral distress. This article explores the dimensions of moral distress among nurses and presents moral fatigue as a holistic experience with both personal and institutional consequences.

Burnout, Professional↗
PubMed2006

The use of moral dilemmas for teaching agricultural engineers.

Agricultural engineers' jobs are especially related to sustainability and earth life issues. They usually work with plants or animals, and the aim of their work is often linked to producing food to allow people to improve their quality of life. Taking into account this dual function, the moral requirements of their day-to-day professional practice are arguably greater than those of other professions. Agricultural engineers can develop their ability to live up to this professional responsibility by receiving ethical training during their university studies, not only by taking courses specifically devoted to ethics, but also by having to deal with moral questions that are integrated into their technical courses through a program of Ethics Across the Curriculum (EAC). The authors feel that a suitable pedagogical technique for achieving this goal is the use of moral dilemmas, following Kohlberg's theory of levels of morality (1981), with the final objective of attaining a post-conventional level. This paper examines the possibilities and limitations of using moral dilemmas as a pedagogical technique for training agricultural engineers. The cases, discussions, and evaluation used in the Agricultural Engineering Department of the Technical University of Valencia (Spain) are also presented.

Agriculture↗
PubMed1990

Depression and moral identity in adolescence.

The theoretical and empirical examination on hand is devoted to the analysis of the relation between depression in adolescence and the development of moral identity. Corresponding to theoretical forecasts a distinct depressive syndrome is found which presupposes the development of feelings of guilt, only with the attainment of the conventional moral level. As ambivalence conflicts have to be seceded and denied to a considerable extent, because of the proximity to real conflicts of the adolescents also the moral dilemmas in the examination according to Kohlberg are distorted and perceived filtered by defence processes; there results, correspondingly, a close connection between the formation of the depression and lower sociomoral level. In the same way, because of the predicted massive ambiguityintolerance of depressive persons also the difference between highest possible judgement level and average level found in relations to the formation of the depression is slighter; the socio-moral development is stimulated correspondingly less. The image of depression in adolescence which correlates with these findings on moral development is equivalent in its dimensions of restricted life world and distorted lifestyle to results gained previously from larger random tests on depressive toning down in adolescence (comp. Reinhard 1986).

Adolescent↗
PubMed1990

The uses of moral ideas in the mastery of trauma and in adaptation, and the concept of superego severity.

The power of moral ideas, here equated with superego strength, has been explained in increasingly complex terms over the course of the development of psychoanalysis. At first regarded mainly as useful in opposing oedipal instinctual demands, morality came to be seen also as opposed to aggressive wishes while at the same time capable of gratifying aggressive and libidinal forces. In this paper, I discuss the contribution to the strength of morality that comes from the effects of painful ("traumatic") experiences and from the use of moral ideas for social, adaptational purposes. In addition I consider the possibility that unchanging moral ideas can have changes in function in clinical work. A case is presented to illustrate these points.

Adaptation, Psychological↗
PubMedDate not supplied

Generalized expectancy, situational perception, and morale among institutionalized aged.

This article was based on a larger study which sought to identify selected personality and situational variables that contribute to high morale of the institutionalized elderly. The relationship of generalized expectancy of control and perceived situational control to morale of the institutionalized aged was examined within a framework developed for the study. Locus of control, self-report, trust, self-rated health, and the Revised Philadelphia Geriatric Morale scales as well as a situational control of daily activities (SCDA) interview schedule were administered individually to 30 residents, aged 65 to 96, in four skilled nursing facilities. Congruence between internal orientation and self-determined SCDA resulted in higher morale than incongruence; however, congruence between external orientation and other-determined situations resulted in lower morale than incongruence.

Adaptation, Psychological↗
PubMed1989

[Moral development in children].

In child psychiatry the developmental aspect is emphasized. Recognition of normal sequence of development in so-called "normal children" makes it possible to reveal pathological conditions (either retardation or acceleration of development, distortion or atypical development). Change-motion-development are philosophical categories considered a manifestation or life--of psychobiological maturation and growth. When investigating the moral development three theories were applied: the developmental theory (Piaget)--learning (Kohlberg), the dynamic theory (Sandler). Among factors which influence in a certain way the moral behaviour the following were selected: age, sex, temperament, family environment. The author describes three stages of moral development in children: preventional stage (moral heteronomy) up to the age of 8 years, conventional and pst conventional (moral autonomy) in adolescence.

Child↗
PubMed1988

Comparison of the general moral reasoning of small animal veterinarians vs large animal veterinarians.

This project was developed to gather data on the general moral reasoning of practicing veterinarians and to compare the responses of small animal veterinarians vs large animal veterinarians and of male veterinarians vs female veterinarians. Using the Defining Issues Test for assessing moral reasoning, it was found that there is no significant difference between the levels of moral reasoning of small animal and large animal veterinarians. However, a slightly significant (P = 0.045) difference was found between the levels of moral reasoning of male and female veterinarians. Explanations of these findings are given. This report provides baseline data on the moral reasoning of veterinarians, which can serve as a foundation and stimulus for comparison in other studies.

Adult↗
PubMed1988

Carol Gilligan's theory of sex differences in the development of moral reasoning during adolescence.

Gilligan's work, which focuses on sex differences in moral reasoning, the perception of violence, the resolution of sexual dilemmas and abortion decisions, poses a major challenge to Kohlberg's theory by introducing a feminist perspective of moral development. Kohlberg had shown that the average female attained a moral judgment rating of stage three (good boy-nice girl), while adolescent males score at level four (law and order) and are more likely to move on to postconventional levels. Gilligan suggests that these findings reveal a gender bias, not that females are less mature than boys. Men and women follow different voices. Men tend to organize social relationships in a hierarchical order and subscribe to a morality of rights. Females value interpersonal connectedness, care, sensitivity, and responsibility to people. Kohlberg's scoring criteria give the interpersonal care orientations of females lower ratings than the principled justice orientation. Hence, Gilligan identifies different developmental stages for females. However, she does not claim that one system is better; both are equally valid. Only by integrating these complementary male (justice) and female (care) orientations will we be able to realize our full human potential in moral development.

Abortion, Induced↗