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Educating nurses about ethics is more complex, multidimensional, and time consuming than educating nurses about technical skills. Many factors, including the ability of the nurse to view situations holistically, the moral development of the nurse, and the institution's ethics, are involved. To illustrate how to teach nurses ethics, two examples of programs are detailed in this article.
This article advances the argument that the inherent virtue/character of the caregiver is an important element in clinical ethical decision making. Virtue should be promoted as an essential component of professional behavior, and specifically emphasized in both medical student education and professional practice.
Today, more than ever, nurses and their patients need to keep pace with the technologic revolution in patient care. There are choices now in health care that patients or their caregivers in the past did not have to face. In making these ethical decisions, nurses rely on systematic problem solving, legal advice, ANA Code of Ethics, Nurse Practice Acts, Patient Bill of Rights, clergy, colleagues, and hospital protocols, along with the examination of their own ideals and morals. Ethics is a complex field, and one must look beyond the surface to examine the incidents in the order in which they occurred. In most situations, therefore, one must look past simplistic statements made about the case. After a detailed analysis, what becomes apparent is that the nurse is not necessarily in the wrong.
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A growing body of research on the way children change their forms of thinking and views of the world from around the ages of 2 to 5 strongly suggests that something called a 'theory of mind' is acquired during this time which significantly affects the course of language acquisition, moral development, interactive problem-solving and other cognitive attributes. As we learn more about the adult varieties of this theory of mind we begin to realise their implications for psychoanalysis. This paper considers such issues as: what kind of theory of mind is assumed by our reliance on the Basic Rule? What kind of theory is required to understand the usual range of standard interventions? How can deficiencies in the analysand's theory of mind interfere with standard interpretations? As research on theory of mind makes us increasingly sensitive to the importance of different forms of thinking about thinking, we can apply many of these insights to common problems of psychoanalytic technique.
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Because of new advances in biomedical science and bio-technology, nurses are confronted with dilemmas for which no easy solutions are available. For this reason, it is becoming increasingly crucial that nursing students develop moral judgement. Nursing students find it difficult to relate the principles of ethics (moral conduct, duty and judgment) to concrete nursing situations. Blondeau (1986) believes the case study to be one of the most effective teaching strategies that can be used to raise moral sensitivity. However, it is very difficult to use this strategy with young adult students. The authors believe that if students learn ethical principles prior to the case study they will become aware of ethical problems and will be better prepared to discuss in depth ethical implications. They designed a self-learning module and compared the results with an equivalent group of students. Post-test cognitive results showed a difference between the two groups. Students using the new case study module expressed great satisfaction with the format, utilization and attitudes of this module. The approach proved useful since students were able to learn at their own pace. The time previously used to teach ethical principles was then allotted to class discussions and the process of ethical decision-making.
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Persons concerned with medical education sometimes argued that medical students need no formal education in ethics. They contended that if admissions were restricted to persons of good character and those students were exposed to good role models, the ethics of medicine would take care of itself. However, no one seems to give much philosophic attention to the ideas of model or role model. In this essay, I undertake such an analysis and add an analysis of role. I show the weakness in relying on role models exclusively and draw implications from these for appeals to virtue theory. Furthermore, I indicate some of the problems about how virtue theory is invoked as the ethical theory that would most closely be associated to the role model rhetoric and consider some of the problems with virtue theory. Although Socrates was interested in the character of the (young) persons with whom he spoke, Socratic education is much more than what role modeling and virtue theory endorse. It-that is, philosophy-is invaluable for ethics education.
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The development of moral identity is linked to a sense of self that is prosocial and connected to others. Youth organizations, if designed appropriately, may provide a setting for social interactions and relationships in which youth can enact and receive validation for moral behaviors and develop prosocial selves. This chapter reports on findings from a four-year study of identity construction within an urban Boys and Girls Club. The author conducted interviews and photography projects with seventeen youth ages twelve to eighteen, all of whom were active club members. Over half described their race or ethnicity as black or African American, while others were Hispanic, Afro-Latino, white, or other. All of them either lived in the housing project near the club or had close ties to it. Both boys and girls describe themselves as rooted in a rich relational milieu that promoted prosocial identities. The importance of respect emerged as a key theme in the teens' narratives about themselves and their activities. The author found that the club served as a site for the development of prosocial traits in an environment characterized by respectful and supportive relationships.
Current focus in the health care ethics literature on the character of the practitioner has a reputable pedigree. Rather than offer a staple diet of Aristotelian ethics in the undergraduate curricula, perhaps instead one should follow Murdoch's suggestion and help the practitioner to develop vision and moral imagination, because this has a practical rather than a theoretical aim. The imaginative capacity of the practitioner plays an important part in both the quality of the nurse's role enactment and the moral strategies which the nurse uses. It also plays a central part in the practitioner's ability to communicate with a patient and in the type of person which the practitioner becomes. Can the moral imagination be stimulated and nurtured? Some philosophers and literary critics argue that not only is this possible, but that literature is the means of doing so. If this is the case then a place should be made for literature in already crowded health care curricula.
The relationships of moral maturity, cognitive reasoning, MA, and CA were investigated with three IQ groups. The subjects were 20 moderately retarded, 20 mildly retarded, and 20 nonretarded individuals matched for MA. The findings indicated that moderately retarded individuals are at lower levels of cognitive reasoning and moral maturity than MA-matched mildly retarded and nonretarded individuals. The findings also indicated a stronger relationship between moral maturity and cognitive reasoning than between MA and moral maturity or MA and cognitive reasoning. The findings were discussed in terms of the positions of Kohlberg and Gilligan (1971) and Taylor and Achenback (1975).
During the 1990s, bioethicists raised questions about certain clinical trials conducted in developing countries. These inquiries led to revisions in the Declaration of Helsinki and recommendations from the US National Bioethics Advisory Commission. This article raises doubts about the original questions and subsequent recommendations. It is possible that impractical solutions have been proposed for nonexistent ethical problems.
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