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PubMed1977

Moral judgement and moral conduct in the psychopath.

The relationship between moral conduct and moral judgment was investigated by comparing moral reasoning of a psychopathic sample from a maximum security hospital for the criminal offender with a similar inmate, nonpsychopathic sample, and a group of "normals". Psychopaths obtained significantly higher scores on the Kohlberg scale of moral judgment than either of the other groups, for whom no differences were found. Results suggest the hypothesis that lack of guilt feelings in psychopaths facilitate the achievement of higher levels of moral judgment.

Antisocial Personality Disorder↗
PubMed1994

Theological ethics, moral philosophy, and public moral discourse.

The advent and growth of bioethics in the United States in the late 1960s and early 1970s precipitated an era of public moral discourse, that is, the deliberate attempt to analyze and formulate moral argument for use in public policy. The language for rational discussion of moral matters evolved from the parent disciplines of moral philosophy and theological ethics, as well as from the idioms of a secular, pluralistic world that was searching for policy answers to difficult bioethical questions. This article explores the basis and content of the unique contributions of both theological and philosophical ethics to the development of public moral discourse.

Advisory Committees↗
PubMedDate not supplied

Moral judgment in middle and late adulthood: the effects of age-appropriate moral dilemmas and spontaneous role taking.

This was a cross-sectional study of the effects of age, sex, and moral dilemma content on adult moral reasoning. Hypothetical dilemmas were presented to sixty men and women, thirty of whom were elderly and thirty in early middle age. With education controlled there were no age or sex differences in moral maturity. Dilemma content had a significant effect on moral judgment, with a tendency for each age group to use a higher level of judgment when the situation described was age-appropriate, i.e., relevant to that group's stage of life. There was a significant age difference on a measure of spontaneous role taking: old persons made more definitive moral judgments than the younger adults, who attempted to reconcile the various points of view represented in a dilemma.

Adult↗
PubMed2002

Moral distress or moral comfort.

Moral distress in healthcare results from a professional's inability to provide compassionate care to patients because of individual, organizational, or societal barriers. Research suggests that moral distress is a growing concern among nurses, and may be a major reason why nurses leave one job for another or abandon the profession of nursing. Some professionals, however, have identified strategies that help them work through their moral distress toward an experience of moral comfort. These strategies may be individual, organizational, or societal. The focus of this paper is to identify examples of strategies professionals have used to alleviate distressful feelings and enhance moral comfort.

Burnout, Professional↗
PubMed1993

Dilemmas of moral distress: moral responsibility and nursing practice.

The experience of moral distress can be distinguished from the experience of moral dilemmas. In moral distress, a nurse knows the morally right course of action to take, but institutional structure and conflicts with other co-workers create obstacles. A nurse who fails to act in the face of obstacles also may have reactive distress in addition to the initial distress. Both kinds of distress pose dilemmas about individual and collective moral responsibility. Coping with these dilemmas effectively requires taking at least some successful actions to resolve distress.

Ethics, Nursing↗
PubMed2026

The Moral of the Story-Perception of Leadership With Moral Distress in Registered Nurses: A Qualitative Systematic Review.

AIM: To understand how Registered Nurses perceive the impact of nursing leadership on managing moral distress and mitigating burnout. BACKGROUND: Moral distress and burnout are pervasive issues in nursing, compromising well-being, patient safety and workforce sustainability. Leadership is a critical factor in shaping workplace culture and mitigating these challenges, yet evidence remains limited. DESIGN: Qualitative systematic review. METHODS: A qualitative systematic review was conducted following JBI methodology and PRISMA guidelines. Comprehensive searches across MEDLINE, PsycINFO, Embase, CINAHL and Scopus identified 5927 articles, with two studies meeting the inclusion criteria. Data were appraised using the JBI Critical Appraisal Checklist and synthesised via meta-aggregation. Confidence in findings was assessed using the ConQual approach. RESULTS: Four major themes emerged: (1) Behind the barriers, (2) Breaking point, (3) Weathering the storm and (4) Leadership for lasting change. Leadership influenced nurses' psychological safety, ethical decision-making and resilience. Inadequate support amplified moral distress, and effective strategies included authentic communication, team solidarity and systemic interventions. CONCLUSIONS: Leadership plays a pivotal role in mitigating moral distress and burnout. Evidence highlights the need for structural changes and support to sustain registered nurses' well-being and retention. RELATIVE TO CLINICAL PRACTICE: Findings offer direction for leadership strategies that promote ethical workplaces, shared decision-making and mental health supports to enhance resilience and patient care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Strengthening leadership capability is vital for workforce sustainability, care quality and nurse retention. REPORTING METHOD: Authors have adhered to relevant EQUATOR guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not involve patients or the public in its design, conduct or reporting.

Leadership↗
PubMed2003

Maternal power assertion in discipline and moral discourse contexts: commonalities, differences, and implications for children's moral conduct and cognition.

Parental power assertion is traditionally studied in the behavioral domain--discipline triggered by the child's immediate misbehavior--but rarely in the cognitive domain--parent-child discussions of the child's past misbehavior. Maternal power assertion was observed in "do" and 'don't" discipline contexts from 14 to 45 months and in the context of mother-child discourse about a recent misbehavior at 56 months. Mothers' use of power cohered across the "do," 'don't," and discourse contexts, but its implications were domain specific. Power assertion in the 'don't" discipline context predicted behavioral outcomes (more moral conduct at 56 and 73 months, less antisocial conduct at 73 months) but not cognitive outcomes (moral cognition at 56 and 73 months). Power assertion in the discourse context predicted less mature moral cognition but not moral or antisocial conduct. Mothers' high Neuroticism predicted more power assertion in all three contexts. Child effects were examined.

Adult↗
PubMed1989

Effects of moral reconation therapy upon moral reasoning, life purpose, and recidivism among drug and alcohol offenders.

40 incarcerated DWI offenders and 62 drug offenders who were treated with Moral Reconation Therapy were assessed with respect to levels of moral reasoning, their perceived purpose in life, and subsequent recidivism. Analysis showed that, as clients progress in the program, levels of moral reasoning and purpose in life increase significantly. Level of moral reasoning appears to increase with clients' completion of therapeutic steps. Preliminary recidivism data on 103 male and female inmate-clients who have participated in an aftercare program using the therapy appear encouraging.

Adult↗
PubMed1999

The moral government of idiots: moral treatment in the work of Seguin.

This paper considers the role which moral treatment played in the treatment of idiots in the nineteenth century and particularly in the work of Edouard Seguin. It uses this discourse to identify some of the key elements of the definition of what constituted the "moral", viz. teleology, discipline and humane treatment. By way of interpretation, moral treatment and the "physiological method" of treating idiocy are presented as being based more on utility in securing the ends of social and productive subjects than on humanitarian notions of care or treatment. In additon, the paper supports the view that moral teatment allowed physicians to claim effectiveness in a field in which success had otherwise eluded them.

France↗
PubMed2005

Moral dilemmas and moral rules.

Recent work shows an important asymmetry in lay intuitions about moral dilemmas. Most people think it is permissible to divert a train so that it will kill one innocent person instead of five, but most people think that it is not permissible to push a stranger in front of a train to save five innocents. We argue that recent emotion-based explanations of this asymmetry have neglected the contribution that rules make to reasoning about moral dilemmas. In two experiments, we find that participants show a parallel asymmetry about versions of the dilemmas that have minimized emotional force. In a third experiment, we find that people distinguish between whether an action violates a moral rule and whether it is, all things considered, wrong. We propose that judgments of whether an action is wrong, all things considered, implicate a complex set of psychological processes, including representations of rules, emotional responses, and assessments of costs and benefits.

Adult↗
PubMed1996

Older and more moral?--age-related changes in performance on Piagetian moral reasoning tasks.

Three age groups (teenage; 50-65 and 65+) completed a written version of Piaget's moral reasoning tasks to determine the general level of moral reasoning and performance on eight separate categories. Significant age effects were found. Though the nature of the age group difference was mixed, younger subjects consistently achieved lower levels of performance. Results indicate that Piaget overestimated all subjects' level of performance on his tasks and that, although there are differences in different areas of moral reasoning, the relationship with age is not uniform in its direction.

Adolescent↗
PubMed1994

A motivational model for understanding moral action and moral development.

The neglected topic of moral action and the explanations given for such actions, with their shortcomings, are discussed. To avoid these limitations a new model is offered which integrates personal and situational variables, wherein motivation for moral action is the result of the interaction among moral motives, expectations about costs/benefits, and expectations about outcomes for self-evaluation. The numerical values for these variables are defined and support for this model is given through a reanalysis of Kohlberg's stages and some data from other researchers.

Humans↗
PubMed1993

Moral sensibilities and moral standing: Caplan on xenograft "donors".

[I]nterest in animals as a source of organs and tissues for human beings remains strong. New developments in immunosuppression technology promise to lower the technical barriers to a routine use of nonhumans as organ donors, and the image of colonies of animals kept at the ready for supplying the growing human need for new organs seems a much more plausible scenario now than it did when broached by transplantation specialists in the Sixties. As Arthur Caplan has powerfully argued, the prospects that other sources of organs may resolve the supply problem are grim.... In the face of these "pro-xenograft" pressures, it becomes all the more signficant to assess arguments against the practice that rest on considerations of the moral status of the nonhumans from whom the organs are taken. To be sure, xenograft faces other moral difficulties -- for example, concerns about the quality of informed consent obtained for recipients, worries about the possibility that xenografting will serve as a vector by which new and possibly virulent viruses become established in humans, and problems about whether such spending is equitable in the light of other unresolved human needs. Yet whether we morally wrong animals in taking their organs and their lives remains a decidedly central issue here, one that cannot be finessed away by developing better informed consent procedures, better anti-viral strategies, or by situating transplantation medicine in a just health care system.

Anencephaly↗
PubMedDate not supplied

Moral outrage and moral discourse in nurse-physician collaboration.

True collaboration between clinical nurses and physicians in acute care settings can be difficult to achieve. The author describes a patient care unit dedicated to the study and development of such collaborative relationships. She reports an unexpected favorable outcome of such collaboration: the decline in incidents of moral outrage among nurses faced with moral dilemmas. This decline is attributed to such factors as mutual trust and respect between nurses and physicians, an appreciation that the two practice areas are interdependent, and the development of a synergistic alliance between the two that enhances patient care.

Aged↗
PubMed1999

The CAD triad hypothesis: a mapping between three moral emotions (contempt, anger, disgust) and three moral codes (community, autonomy, divinity).

It is proposed that 3 emotions--contempt, anger, and disgust--are typically elicited, across cultures, by violations of 3 moral codes proposed by R. A. Shweder and his colleagues (R. A. Shweder, N. C. Much, M. Mahapatra, & L. Park, 1997). The proposed alignment links anger to autonomy (individual rights violations), contempt to community (violation of communal codes including hierarchy), and disgust to divinity (violations of purity-sanctity). This is the CAD triad hypothesis. Students in the United States and Japan were presented with descriptions of situations that involve 1 of the types of moral violations and asked to assign either an appropriate facial expression (from a set of 6) or an appropriate word (contempt, anger, disgust, or their translations). Results generally supported the CAD triad hypothesis. Results were further confirmed by analysis of facial expressions actually made by Americans to the descriptions of these situations.

Culture↗
PubMed2003

Does morality have a biological basis? An empirical test of the factors governing moral sentiments relating to incest.

Kin-recognition systems have been hypothesized to exist in humans, and adaptively to regulate altruism and incest avoidance among close genetic kin. This latter function allows the architecture of the kin recognition system to be mapped by quantitatively matching individual variation in opposition to incest to individual variation in developmental parameters, such as family structure and co-residence patterns. Methodological difficulties that appear when subjects are asked to disclose incestuous inclinations can be circumvented by measuring their opposition to incest in third parties, i.e. morality. This method allows a direct test of Westermarck's original hypothesis that childhood co-residence with an opposite-sex individual predicts the strength of moral sentiments regarding third-party sibling incest. Results support Westermarck's hypothesis and the model of kin recognition that it implies. Co-residence duration objectively predicts genetic relatedness, making it a reliable cue to kinship. Co-residence duration predicts the strength of opposition to incest, even after controlling for relatedness and even when co-residing individuals are genetically unrelated. This undercuts kin-recognition models requiring matching to self (through, for example, major histocompatibility complex or phenotypic markers). Subjects' beliefs about relatedness had no effect after controlling for co-residence, indicating that systems regulating kin-relevant behaviours are non-conscious, and calibrated by co-residence, not belief.

Adolescent↗
PubMed2003

Parents as caregivers for children with schizophrenia: moral dilemmas and moral agency.

Because the ability of people with schizophrenia to achieve anticipated success and independence is compromised, many of their parents assume responsibility for protecting, nurturing, and directing care for their offspring. The emotional, social, and financial challenges of caregiving, extended beyond the usual child-rearing duration, are complicated by the societal designation of their children as adults. Decisions about caregiving involve many practical and moral dilemmas. In this article, we examine several dilemmas encountered by parents who try to fulfill their perceived responsibility to care for adult children with schizophrenia. After exploring the related concept of moral agency, we close with some reflections on the assumptions surrounding psychiatric care and parental responsibility.

Adolescent↗
PubMed2005

Depression is the predominant factor contributing to morale as measured by the Philadelphia Geriatric Morale Scale in elderly Chinese aged 70 years and over.

OBJECTIVE: To examine factors contributing to the total Philadelphia Geriatric Morale Scale (PGMS) and its two subscales: reconciled ageing and unstrained affect. METHOD: The PGMS was administered to 759 community-living subjects aged 70 years and over. Information regarding socioeconomic status, health conditions, sensory impairment, physical symptoms, social support, activities of daily living as measured by the Barthel Index, life satisfaction, and the Geriatric Depression Score, was collected. Associations between these factors and PGMS and its subscale were examined using univariate analysis (Mann-Whitney; Kruskal-Wallis tests), and multivariate analysis using the classification and regression tree (CART) method. RESULTS: Gender, old age, physical, socioeconomic and social factors were significantly associated with PGMS. There was a strong correlation with GDS (r = 0.77, p < 0.001). In the CART analysis, for both subscales and the total score, GDS was the predominant factor contributing to the score. Other factors include self perception of health, enough expenses, overall satisfaction with life, gender, and constipation. DISCUSSION: The PGMS and GDS are closely related. In addition to the GDS, health perception, life satisfaction, and adequate finance were factors contributing to quality of life in elderly Hong Kong Chinese.

Activities of Daily Living↗