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PubMed1984

[The Flemish author Hendrik Conscience (1812-1883) and the psychiatric patients of Geel].

The Flemish author Hendrik Conscience (1812-1883) whose novels were translated in the 19th century into all European languages, wrote also a mainly unknown, romantically elaborated story which was only translated into French under the title " Eene Gekkenwereld ", in which the system of psychiatric family care plays a leading rôle. After the presentation of a psychopathographic sketch of the personality of Conscience this is followed by a brief information on the contents. In this connection the psychopathologically and social-psychiatrically relevant passages are briefly examined and analysed. The work comes to the conclusion that in the literary field Conscience may be regarded as a pioneer of the humanisation of the early scientific psychiatry to which in the atmosphere of the psychiatric family care in the Flemish place Geel the social-psychiatric element had been already permanently adopted.

Famous Persons↗

PubMed1990

Conscience and courage--a critical examination of professional conduct.

The roots of professional power and authority lie in the claim to a specific kind of knowledge, the 'knowledge that' and the 'knowledge how'. These kinds of knowledge are included in the notion of 'science'. 'Knowledge why'- the justification for a professional action - demands a moral argument in terms of what is known and can be done (taking 'scientific' knowledge into account) but most importantly asking whether it ought to be done. It is important to ask how a nurse acquires the 'knowledge why' and thereby the means to justify his/her conduct in moral terms. This paper considers the norms of professional conduct, the professional mandate and the determination of what is, to the best of the professional's knowledge and conscience, the right act. The question is raised whether an appeal to the individual conscience can be a reliable guide to a morally justifiable action. An exploration of moral perceptions, moral reasoning and moral argument needs to be part of a professional education which requires a certain kind of courage on part of both teachers and students.

Codes of Ethics↗

PubMed1975

Catecholamine excretion, conscience function and aggressive behaviour.

This report deals with a study--carried out among 46 12-17-year-old-boys--of the relationship between: (1) the excretion of waste products of catecholamines (methyladrenaline and methylnoradrenaline) and creatinine, (2) aggressive behaviour in a laboratory setting, and (3) data obtained via a conscience-function questionnaire. The hypothesis that aggressive behaviour is positively correlated with methylnoradrenaline excretion was confirmed. As far as the conscience-function questionnaire was concerned, three dimensions could be distinguished. Methyladrenaline and methylnoradrenaline excretion proved to be reversely related to one of them, indicated as the 'intropunitiveness-aggressiveness dimension'. Intropunitive subjects appeared to have a higher methyladrenaline and a lower methylnoradrenaline excretion than aggressive subjects. The aforesaid dimension also correlated significantly with creatinine excretion, a finding which led to the interpretation that aggressive people possess greater muscular strength than more intropunitively inclined people. However, no significant correlations between aggression scores and questionnaire scores were found. The results are discussed against the background of arousal theories of aggressive behaviour.

Adolescent↗

PubMedDate not supplied

Compliance with patients' end-of-life wishes by nursing homes in New York City with conscience policies.

Nursing home patients have a constitutional right to refuse treatment. The Patient Self-Determination Act confirmed that right. State laws address the obligations of health care providers and facilities to honor that right. The New York State law is more specific than those of many other states. It allows exemptions for "reasons of conscience" and imposes a number of requirements on nursing homes claiming such an exemption, including the transfer of a patient to a home that will honor an end-of-life wish. This study, conducted by FRIA, investigated the refusal of some nursing homes in New York City to carry out patients' end-of-life wishes because of conscience-based objections. The study also investigated the willingness of homes which did not have such policies to accept patients transferring from a home with a policy so that the patient's end-of-life wishes would be honored. Implications for administrators, policy makers, and regulators are discussed.

Advance Directive Adherence↗

PubMed1995

Assessing Machiavellianism and Morality-Conscience Guilt.

If Machiavellians behave relatively morally or ethically as stated by Leary and colleagues in 1986, then hypotheses regarding their immorality should be reexamined. 84 MBA students in a program at Fairleigh Dickinson University completed Christie and Geis' 1970 Mach IV scale and the Guilty-Conscience subscale of Mosher's 1988 Revised Mosher Guilt Inventory. Results indicate that some students scored high on both Machiavellianism and Morality-Conscience Guilt.

Adult↗

PubMed1997

Inhibitory control as a contributor to conscience in childhood: from toddler to early school age.

In this article we report a longitudinal extension of previous findings about the critical role of temperamental inhibitory or effortful control as the contributor to developing conscience in young children. A comprehensive observational battery, highly internally consistent, was developed to measure inhibitory control in 83 children at early school age who had been followed since toddlerhood and had been assessed using similar batteries at toddler and preschool age. We again confirmed the findings of robust longitudinal stability of inhibitory or effortful control, now from toddler to early school age, the increase with age, and gender differences, with girls outperforming boys. We also reaffirmed strong links, both contemporaneous and in the longitudinal sense, between inhibitory control and multiple, diverse measures of children's conscience at early school age, including observations of moral conduct, moral cognition, and moral self. The findings are discussed in view of the increasingly appreciated importance of temperament for critical aspects of socialization.

Child↗

PubMed1998

Physician's conscience and HECs: friends or foes?

No matter the future of healthcare financing and management, physicians of conscience and integrity must still be an important force in the consideration of ethical issues. The traditional role for the conscientious physician--being the only or even the major determinant of the morality of specific clinical decisions--is, for better or worse, no longer in effect. Much of this authority now belongs to patients and HECs are the mechanism within HCOs to help maintain this authority and to observe, comment on, recommend, and occasionally "regulate" the ethics of the healthcare arena. It is natural that these mechanisms for addressing areas of moral uncertainty create a certain tension. This tension should be acknowledged by conscientious physicians and HEC members. Total agreement on all moral issues in the clinical setting is impossible and should not be a goal. However, the respectful recognition of the importance of each perspective by both HEC members and conscientious physicians, and cooperation in developing effective mechanisms to address real differences, are possible and desirable. All who are interested in the ethics of healthcare now and in the future should support these endeavors.

Committee Membership↗

PubMed1992

On the definition of the concepts thinking, consciousness, and conscience.

A complex system (CS) is defined as a set of elements, with connections between them, singled out of the environment, capable of getting information from the environment, capable of making decisions (i.e., of choosing between alternatives), and having purposefulness (i.e., an urge towards preferable states or other goals). Thinking is a process that takes place (or which can take place) in some of the CS and consists of (i) receiving information from the environment (and from itself), (ii) memorizing the information, (iii) the subconscious, and (iv) consciousness. Life is a process that takes place in some CS and consists of functions i and ii, as well as (v) reproduction with passing of hereditary information to progeny, and (vi) oriented energy and matter exchange with the environment sufficient for the maintenance of all life processes. Memory is a complex of processes of placing information in memory banks, keeping it there, and producing it according to prescriptions available in the system or to inquiries arising in it. Consciousness is a process of realization by the thinking CS of some set of algorithms consisting of the comparison of its knowledge, intentions, decisions, and actions with reality--i.e., with accumulated and continuously received internal and external information. Conscience is a realization of an algorithm of good and evil pattern recognition.

Artificial Intelligence↗

PubMed2004

The nature and limits of the physician's professional responsibilities: surgical ethics, matters of conscience, and managed care.

The nature and limits of the physician's professional responsibilities constitute core topics in clinical ethics. These responsibilities originate in the physician's professional role, which was first examined in the modern English-language literature of medical ethics by two eighteenth-century British physician-ethicists, John Gregory and Thomas Percival. The papers in this annual clinical ethics number of the Journal explore the physician's professional responsibilities in the areas of surgical ethics, matters of conscience, and managed care.

Conscience↗

PubMed2006

A comparison between habituation and conscience mechanism in self-organizing maps.

In this letter, a preliminary study of habituation in self-organizing networks is reported. The habituation model implemented allows us to obtain a faster learning process and better clustering performances. The habituable neuron is a generalization of the typical neuron and can be used in many self-organizing network models. The habituation mechanism is implemented in a SOM and the clustering performances of the network are compared to the conscience learning mechanism that follows roughly the same principle but is less sophisticated.

Algorithms↗

PubMed1999

Jehovah's Witnesses' refusal of blood: obedience to scripture and religious conscience.

Jehovah's Witnesses are students of the Bible. They refuse transfusions out of obedience to the scriptural directive to abstain and keep from blood. Dr Muramoto disagrees with the Witnesses' religious beliefs in this regard. Despite this basic disagreement over the meaning of Biblical texts, Muramoto flouts the religious basis for the Witnesses' position. His proposed policy change about accepting transfusions in private not only conflicts with the Witnesses' fundamental beliefs but it promotes hypocrisy. In addition, Muramoto's arguments about pressure to conform and coerced disclosure of private information misrepresent the beliefs and practices of Jehovah's Witnesses and ignore the element of individual conscience. In short, Muramoto resorts to distortion and uncorroborated assertions in his effort to portray a matter of religious faith as a matter of medical ethical debate.

Attitude to Health↗

PubMed2001

The place for individual conscience.

From a liberationist, feminist, and Catholic point of view, this article attempts to understand the decision of abortion. People are constantly testing their principles and values against the question of abortion. Advances in technology, the rise of communitarianism and the rejection of individualism, and the commodification of children are factors in the way in which the abortion debate is being constructed in society. The paper offers solutions to end the ugliness of the abortion debate by suggesting that we would be able to progress further on the issue of abortion if we looked for the good in the opposing viewpoint. The article continues with a discussion of Catholics For a Free Choice's position on abortion, and notes firstly that there is no firm position within the Catholic Church on when the fetus becomes a person; secondly that the principle of probablism in Roman Catholicism holds that where the church cannot speak definitively on a matter of fact (in this case, on the personhood of the fetus), the consciences of individual Catholics must be primary and respected, and thirdly that the absolute prohibition on abortion by the church is not infallible. In conclusion, only the woman herself can make the abortion decision.

Abortion, Legal↗

PubMed1997

Institutional identity, integrity, and conscience.

Bioethics has focused on the areas of individual ethical choices -- patient care -- or public policy and law. There are however, important arenas for ethical choices that have been overlooked. Health care is populated with intermediate arenas such as hospitals, nursing homes, hospices, and health care systems. This essay argues that bioethics needs to develop a language and concepts for institutional ethics. A first step in this direction is to think about institutional conscience.

Bioethics↗

PubMed2000

[The moral conscience in the depressive patient].

The two fundamental forms of the depressive guilt are the feeling of guilt and the delusion of guilt. Both phenomena emanate from a conscience distorted because of the depressive mood by means of an holothymic and catathymic mechanism. Also the other three dimensions of depression (anergy, discommunication and rhythmopathy) take part in producing this moral distortion. The appearance of the depressive guilt happens only when these two factors are present: a previous personality with a great spiritual development and a complete or tetradimensional depression. Shame and distrust replace the guilt in the asiatic and african countries.

Conscience↗

PubMed1991

Dreams, conscience, and memory.

The interpretation of certain dreams, as opposed to the direct examination of behavior, makes it possible to explore the conscience of the dreamer, detect hidden sources of guilt, and interpret them with less likelihood of arousing intractable resistance. Through the recovery of memories and the establishment of an intimate familiarity with one's personal history, it becomes possible to resolve problems of "neurotic" guilt, based ultimately on distortions of repressed childhood memories. The resolution of these conflicts allows a greater role for the operation of "appropriate" guilt, based on genuine transgressions, and the establishment of a more mature ethical structure.

Adult↗

PubMed1989

Shame as an impetus to the creation of conscience.

Shame 'absorbed by' guilt is an issue that was flagged for consideration by Erikson. The most compelling reason for using guilt to obscure shame is that guilt is associated with a sense of the self as strong, though burdened and culpable, whereas shame brings with it a painful sense of vulnerability. Erikson described the way in which compulsive ordering-about of the self allows a child to feel less helpless and less vulnerable to the shame affect. In instituting this type of self-directive behaviour, the child is developing conscience. The irony of this type of self-manipulation is that ultimately the child, or adult, finds himself again burdened by impotence, though it is the impotence of guilt rather than that of shame. The topic of shame yielding to guilt is of interest in part because it demonstrates the highly interactive relationship between narcissistic concerns and superego responses to impulse-expression, and the role of such interactions in the formation of psychological structures.

Adolescent↗

PubMed1982

The voice of conscience and the sounds of the analytic hour.

Two patients reacted to sudden, unexpected, adventitious sounds during an analytic session as though they had been warmed that they would be punished for their misdeeds. One promptly confessed to wrongdoings which she had been denying or keeping secret. It was as though a "voice of conscience" had spoken to them to remind them of their obligations, demand compliance with the rules, and threaten them with dire punishments should they fail to obey. The sounds seemed to be experienced as a re-externalized admonishing parental voice that had been incompletely internalized in the course of superego development. Conflicts involving guilt over objectionable fantasies and acts, in part connected with primal scene experiences, appeared to be involved.

Adult↗

PubMed2002

Freud's "bad conscience": The case of Nietzsche's Genealogy.

This article develops the argument that Friedrich Nietzsche influenced several aspects of Freud's later writings by illustrating, in particular, the impact of Nietzsche's On the Genealogy of Morals on Freud's Civilization and its Discontents. The theoretical and conceptual schemes represented in Freud's Discontents are found to bear a remarkable similarity to Nietzsche's Genealogy on a number of highly specific points. It is suggested that "DAS ES," "Uber-ich," and "bad conscience," concepts central to Freud's moral theory of mind, are at least partly derived from Nietzsche. Moreover, Freud's phylogenetic theory of guilt is based upon premises found in Nietzsche, as are specific details relating to ideas on human prehistory and the ancestral family. Based on this evidence, a re-examination of the moral and social dimensions of Freud's "structural" model may be in order.

History, 19th Century↗