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PubMed1985

Hypnotic age regression and moral reasoning.

Moral reasoning was assessed with two dilemmas from the Kohlberg Moral Judgment Interview (1976) in 7 adults who were hypnotically age regressed to four ages: 15, 12, 9, and 6 years. Seven adults in a control group under task-motivation instructions were age regressed to the same ages and administered the dilemmas. Age-regressed moral maturity scores for both groups were compared to pretest scores, to data for actual 15-, 12-, 9-, and 6-year-olds from other studies, and to each other. Both groups were able to lower their moral reasoning scores when given age-regression instructions; however, hypnosis subjects not only scored lower than task-motivation subjects but also more closely resembled the levels of reasoning used by children at these ages. The results provide some support for a distinction between age regression through hypnosis and age regression through task-motivation instructions.

Adolescent↗
PubMed1988

An attempt to induce lower moral reasoning under hypnotic and task-motivated age regression.

In this study, we attempted to partially replicate and extend the findings of the Page (1985) study of hypnotic age regression and moral reasoning. The Kohlberg (1976) Moral Judgment Interview (MJI) was used to assess the initial stage of moral reasoning in 32 adults who were preselected on the basis of their hypnotic susceptibility. Subjects were hypnotized and age regressed to two of four possible ages (16, 13, 10, and 7), or were given task-motivation instructions before being age regressed. All were then administered the MJI, which involves the resolution of certain dilemmas. Both groups were able to lower their moral reasoning scores when given age regression instructions, but no significant differences were found between groups. Thus the results of this study are inconsistent with those of Page (1985), but are consistent with those of O'Brien et al. (1977). Reasons for the failure to reaffirm the earlier results of Page (1985) are discussed.

Adolescent↗
PubMed1999

The influences of behavior valence and actor race on black and white children's moral and liking judgments.

Preschoolers, 1st graders, and 4th graders were shown line drawings that depicted 2 prosocial and 2 aggressive behaviors. Black actors or White actors were depicted in the scenarios, and a brief description of each behavior was read to the child. For each scenario, children rated their liking for the actor and the morality of the actor's behavior. Findings indicated that children at each age level significantly differentiated the actors by behavior valence for moral and liking judgements. However, the moral judgements of White preschoolers were more differentiated by behavior valence than the judgments of Black preschoolers. Also, there was more differentiation of actors by behavior valence for liking judgments as the age levels of the children increased. Black actors received more negative moral judgments than did White actors only at the preschool level.

Black or African American↗
PubMed1990

Children of perpetrators of the Holocaust: working through one's own moral self.

The present study tests stages in the ability of some children of perpetrators of the Holocaust in Germany to work through emotional and moral issues regarding their fathers' perpetrating role during the Third Reich. The following questions are raised: Did they try to distance themselves by playing down the Holocaust and the moral meaning of their fathers' involvement in it? Did any children try to work through issues relating to their fathers' impaired morality? Did any children successfully reach the stage of integration? Fifty-seven persons were contacted by the author between September 1985 and June 1987, of whom 9 refused to be interviewed. Thirty interviewees were children whose fathers had taken an active part in the implementation of the euthanasia program, in the Einsatzgruppen, in the extermination camps or in related activities. The fathers of the remaining 18 interviewees were affiliated with SS units at times and in places where the atrocities took place, but what they actually did or did not do was not proven. In general, there was an almost total silencing of accounts of the extermination process in homes and schools. Acknowledgment, if any, of the atrocities appeared through accounts of trials and friends and in newspapers or, only recently, through the children's active searching. When children who learned what their father-perpetrator had done during the war also came to understand the moral implications, they usually experienced severe emotional conflict, which they had to confront on their own. Only a few succeeded in walking across a very narrow bridge to a working through of the related issues and emotions. The implications of the present analysis for future research on the prevention and outcomes of genocide are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Moral survival in a nontherapeutic environment.

The aim of this study was to examine the ethical decision-making process used by a group of psychiatric and mental health nurses in Canada. Researchers used the constant comparative method of grounded theory to simultaneously collect and analyze data. Data were collected through the use of focus groups of experienced psychiatric and mental health nurses. In addition to focus groups, participant observation and a number of formal and informal interviews were conducted. The contingency for the nurses in this study was the degree of support for professional nursing practice within the cultural context in which they worked. Moral survival in nontherapeutic environments was identified as the basic social process by which the nurses attempted to manage or ameliorate their ethical difficulties in their workplaces. Survival strategies included the doctor-nurse game, covering your backside, running interference, doctor-bashing, administration bashing, scapegoating, and the breakdown of teamwork. The findings revealed nursing strategies that were aimed at surviving in what were perceived as nontherapeutic environments. These strategies are morally significant because the dilemmas concern a moral responsibility that cannot be delegated to others. The moral dilemmas are whether to (a) promote one's own survival or to take care of patients, and (b) be held responsible for one's own actions or to place responsibility on others.

Adaptation, Psychological↗
PubMedDate not supplied

Why did she do that? Issues of moral conflict in battered women's decision making.

This qualitative research study was undertaken, in part, in an effort to develop an understanding of decisions experienced as moral conflicts by women who have experienced abuse by an intimate partner. Eighteen rural women who had been or were currently in an abusive relationship with a male partner participated in the study. An adaptation of the Real-Life Moral Conflict and Choice Interview (L. M. Brown, 1988) was used to gather and interpret the data. This method required each participant to describe a real life dilemma and her response to that dilemma. In this article the author discusses the types of decisions described by the women. The decisions are organized into 3 categories that emerged from the interview narratives: the decision to leave the abusive relationship, decisions that threaten sense of self, and decisions of resistance. The findings of this study make explicit some of the dimensions of moral conflict inherent in decisions battered women make. Explication of these moral conflict issues and the ways in which women seek to resolve them provide another avenue through which to understand a battered woman's life, a perspective not found in other studies.

Adult↗
PubMed2005

The virtue of moral responsibility and the obligations of patients.

The American Medical Association has provided a list of patient responsibilities, said to be derived from patient autonomy, without providing any justification for this derivation. In this article, the virtue of moral responsibility is proposed as a way to justify these kinds of limits on respect for individual autonomy. The need for such limits is explained by examining the traditional principles of health care ethics. What is missing in health care decision making, and can be provided by the virtue of moral responsibility, is a careful consideration of the impact of individual decisions on particular others and the community, as a whole. The concept of moral responsibility as a virtue is then developed and examples of its application to health care decision making are provided. Finally, the roles of both physicians and health care ethicists in promoting the morally responsible exercise of individual autonomy are explored.

Bioethics↗
PubMed2005

Palliative care teams: effective through moral reflection.

Working as a multidisciplinary or interdisciplinary team is an essential condition to provide good palliative care. This widespread assumption is based on the idea that teamwork makes it possible to address the various needs of the patient and family more effectively. This article is about teamwork and about the effectiveness of teams working in palliative care. First, the nature of teamwork will be highlighted. Second, attention will be paid to team effectiveness; what exactly is team effectiveness and with what parameters can it be measured? Third, the nature of moral reflection and moral deliberation in palliative care will be highlighted. A concrete process of moral deliberation will be described. In conclusion, we shall argue that the capacity for moral reflection is a feature of a team working effectively.

Humans↗
PubMed2005

Between morality and repentance: recapturing "sin" for bioethics.

Distinguishing within "sin" the dimensions of anomia, hamartia, and asthenia makes it possible to analyze in greater detail the contrary manners in which traditional and post-traditional Christianities in this issue of Christian Bioethics endeavor to recapture what was lost when secular bioethics reconstructed the specifically spiritual-context-oriented normative commitments of Christianity in one-dimensionally moral terms. Various post-traditional attempts at securing moral orientation and resources for forgiveness, both of which secular bioethics finds increasingly difficult to provide, are critically reviewed. Their engagement of secular moral concepts and concerns, and even their adoption of an academically philosophical posture and language, is presented as responsible for their failure to adequately preserve what in traditional Christianity would count as prohibited vs. permitted, and advisable vs. non-advisable, or what would allow to resolve "tragic conflicts." The deeper reason for this failure lies in post-traditional Christianity's restricting the Christian life (with its central tension between love and the law) to what can be captured by cognitive categories. As the survey of several traditionally Christian accounts of sin in bioethics makes clear, both moral orientation (along with the resolution of "tragic" conflicts) and the sources of forgiveness are available, once that Christian life is framed in terms of persons' spirit-supported practical involvement in ascesis and liturgy, and once bioethical reflections are situated in the experiential context of such involvement.

Bioethics↗
PubMed2004

Medicine and morals, craving and compulsion.

Thinking about addictions has been dominated by two models: the medical model, which treats addiction as a disease and related behaviors as signs and symptoms, and the moral model, which views addiction and related behaviors as indications of moral failure. This article describes both models and their implications, with special emphasis on the moral model. The meaning of compulsion or coercion caused by internal psychological states, such as craving, is explored to determine if addicts may fairly be held morally and legally responsible for their behavior, such as seeking and using substances. It is argued that diminished rationality better explains than compulsion why addicts might be excused for their behavior, but it is concluded that most addicts can be held responsible for most addiction-related behavior. Nonetheless, both models have desirable characteristics, and sound public policy should not be based solely on either. The implications for criminal justice of employing both models to guide policy are explored.

Attitude to Health↗
PubMed1995

Moral content, tradition, and grace: rethinking the possibility of a Christian bioethics.

Birth, suffering, disability, disease and death were by medicine's successes placed within a context of seemingly novel challenges that cried out for new responses. Secular bioethics rose in response to the demands of these new biomedical technologies in the context of culture fragmented in moral pluralism. While secular bioethics promised to unite persons separated by diverse religious and moral assumption, this is a promise that could not be fulfilled. Reason alone cannot provide canonical, content-full moral guidance or justify a moral community capable of binding all persons. Christian bioethics, as part of a way of life enbedded in authentic worship, offers content, meaning and understanding where secular bioethics has failed. For Christians, resolution of bioethical controversies will not be found through appeals to foundational rational arguments or isolated scriptural quotations, but only in a Christian community united in authentic faith.

Bioethical Issues↗
PubMed1975

The Philadelphia Geriatric Center Morale Scale: a revision.

The 22-item Philadelphia Geriatric Center (PGC) Morale Scale was subjected to a series of principal component analyses utilizing different item pools and rotating differing numbers of factors. Subjects were 1086 tenants of federally-assisted housing for the elderly and older people living in the community. Results were compared with analyses of the PGC Scale done by Morris and Sherwood. Consideration of factors defined by the analyses suggested three consistently reproduced factors: Agitation, Attitude Toward Own Aging, and Lonely Dissatisfaction, utilizing 17 of the original items. These results were compared with other multi-dimensional measures of morale: the Bradburn Affect Balance Scale, and morale scales reported by Pierce and Clark, and Schooler. In addition to the dimensions derived from the current study related domains of self-rated health, social accessibility, generalized attitude toward aging, and positive affect were suggested as worthy of further exploration as dimensions of morale.

Aged↗
PubMed1980

Social integration and morale: a re-examination.

The concern for social integration among the aged lies in its implications for well-being in old age. Evidence about the link between social integration and morale is still inconclusive. This appears to be due to poor conceptionalization and lack of specification concerning the relationships between social integration and other correlates of morale. In this study, social integration is viewed in terms of both its subjective and objective aspects. The central hypothesis is that the relationship between objective aspects of social integration and morale is mediated by the subjective sense of integration. This hypothesis was examined through the use of a structural equation model. Four data sets were used for this inquiry which included surveys conducted in North Carolina, Wisconsin, Minnesota, and Detroit. Findings indicate that objective social integration only has an indirect impact on morale, with subjective sense of integration being the intervening variable. This relationship remains significant even when other factors such as socioeconomic status, financial satisfaction, and health status were controlled.

Aged↗
PubMed2001

From the urban to the civic: the moral possibilities of the city.

Relating bioethics to the philosophy of the city creates the possibility for developing the field along paths not yet explored. In the Western tradition, the city has been understood as the venue for two quite different forms of activity and two different types of moral possibility. In one guise, the city is an urbs, a center of commerce, market exchange, and social individualism. In another guise, the city is a civitas or polis, the space of active democratic citizenship, equality under law, and civic virtue. As civitas, classical philosophers regarded the city as the place of moral growth and full human self-realization. These two possibilities of human moral and political experience in the city have given rise to distinct traditions of political theory--liberalism and civic republican and democratic theory. This article traces these conceptual configurations into the domain of contemporary bioethics, arguing that most work in the field has drawn on the liberal tradition and hence has been insufficiently critical of the moral paradigm of market individualism and unduly inattentive to the values of civitas and the civic tradition. It argues for the creation of a form of civic bioethics and explores some of the theoretical foundations that type of bioethics would require.

Bioethics↗
PubMed1997

Moral imperatives for academic medicine.

As the health care system becomes dominated by managed care, academic medicine must do more than simply learn how to continue to offer the same level of care with ever-tightening resources and in new practice environments. Three moral imperatives must guide how medicine is practiced and taught: (1) patients' health and well-being must always be foremost, centered in quality of care and respect for life; (2) the emotional and spiritual needs of patients must be considered, not just the physical needs; (3) academic medicine must instill in its trainees discipline, passion, and skills to meet their obligation to be lifelong learners. These imperatives make it more important than ever for medical educators to tackle two crucial questions: What kind of person makes the best possible physician? And what constitutes the best possible training for that person? Taking these questions seriously in the new era of health care may mean that medical educators need to rethink the teaching of medicine. One example of how this might be done is the Curriculum for 2002 Committee recently formed at the Wake Forest University School of Medicine. It is becoming clear that medical educators can do a better and more comprehensive job of helping future physicians uncover and strengthen their own morality and, in the face of managed care's pressures, renew their loyalty to medicine as a service rather than a business. Morally sensitized physicians can better deal with the hard issues of medicine, such as euthanasia and abortion, and can help their students examine these issues. Most important, they can show their students that physicians are members of a moral community dedicated to something other than its own self-interest.

Attitude of Health Personnel↗
PubMed2000

Moral reasoning, professionalism, and the teaching of ethics to orthopaedic surgeons.

Moral reasoning is not the only component of moral behavior, but it is an important and measurable constituent. Eighty orthopaedists, who took a standardized test of moral reasoning, showed marked heterogeneity in scores, ranging from the level of junior high students to the level of moral philosophers. This variability poses difficulty for those who plan educational courses in ethics, but is not an insurmountable difficulty.

Ethics, Medical↗
PubMed1993

An analysis of job morale factors of community health nurses who report a low turnover rate. The research.

Nurse executives are continually faced with issues related to nursing turnover and staff morale. This sample included 217 registered nurses working in a state health department where the turnover rate was 8%. In this study, the authors found that nurses with advanced educational preparation, higher-level positions, or both, demonstrated increased levels of morale. Conversely, nurses with increased years of service and nursing experience had lower morale levels. These findings could be useful in delineating situations to improve morale and lower turnover rates.

Adult↗
PubMed1992

Assessing quality of life. Moral implications for clinical practice.

The purpose of this paper is to examine some of the moral implications for clinical practice of the move toward measuring or assessing quality of life. For purposes of this presentation, discussions of the good life or quality of life have at least two "conceptual" preconditions. First is biologic life; second is a minimum cognitive apparatus to attach meaning to life (or a capacity for self-awareness). Quality of life measurement in clinical care has three principal uses: screening, monitoring, and decisionmaking. The paper discusses how increasing reliance on quality of life measures is potentially morally appealing in all these cases, but also how moral "downsides" may be created that should be recognized and confronted with appropriate moral constraints.

Beneficence↗