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PubMedDate not supplied

Progress in the moral reasoning of baccalaureate nursing students between program entry and exit.

Changes in moral reasoning between entry into and exit from a baccalaureate nursing program and the relationship between student characteristics and moral reasoning at entry and exit were explored in this descriptive study. The moral reasoning of four cohorts of students was measured using the Defining Issues Test (DIT). Admission grade point average, prior college credits, and gender accounted for 10% of the variance in DIT P% scores at entry and 14% of the variance at exit from the program. Female students had significantly higher moral reasoning scores than men. Age did not contribute significantly to explaining DIT score variance. DIT P% scores at entry for all four cohorts were within the range of reported norms for college students. Exit scores for all four cohorts were between the normative means for undergraduate students and graduate students. DIT P% score gains between entry and exit were significant for all four cohorts. Students whose entry scores were in the lowest categories had the greatest mean gains.

Adult↗

PubMed1986

The moral foundation of nursing.

The authors argue that the moral predicament facing nurses is their not being free to be moral because they are deprived of the free exercise of moral agency. Two occurrences are needed for nurses to be free to be moral: (1) the emergence of a strong sense of professional autonomy for nurses and (2) a shift in the locus of accountability from other health care professionals to the patient. The direction urged is to view nursing ethics as reform ethics.

Conflict, Psychological↗

PubMedDate not supplied

Taking responsibility: toward an understanding of morality in practice: a critical review of the empirical and selected philosophical literature on the social organization of responsibility.

Although the nursing literature overflows with references to the myriad things for which nurses and patients are de facto responsible, nurses have never explicitly examined the social construction of responsibility in any clinical context. This article reviews and integrates the empirical and philosophical literature on moral responsibility in the context of mental health nursing. It selectively reviews both traditional and feminist philosophical accounts to more deeply understand the socially constructed nature of responsibility and the implications for understanding morality in practice. It seeks to illuminate the concept of "taking responsibility" qua moral responsibility and asks what makes this notion of responsibility particularly "moral."

Ethics, Nursing↗

PubMedDate not supplied

Moral turpitude: a benchmark toward eligibility for registered nurse licensure?

The purpose of this descriptive study was to explore the concept of moral turpitude and related terms as they are used in the process of licensing professional nurses. The researchers reviewed applications for licensure and nurse practice acts or rules and regulations for nursing for the 50 states and Washington, DC. Terms such as moral turpitude, moral character, and morality are used by approximately half of the states and, when used, are not usually defined. Agreement among states on uniform definitions and standards of nursing practice can be a step toward aligning practice acts, bringing consistency to disciplinary actions, and informing the public about the profession's standards for practice.

Benchmarking↗

PubMed2001

Moral perception and global visions.

Because moral perception plays an essential role in guiding morally responsible behaviour, agents have a responsibility to develop their capacities in this area. There are several strategies agents can (and should) pursue in order to improve their skills at moral perception. I appeal to insights derived from the work of feminist epistomologists [sic] and philosophers of science to argue that feminist approaches to multiculturalism are particularly valuable tools for improving moral perception.

Bioethics↗

PubMed1994

Universal prescriptivism: traditional moral decision-making theory revisited.

Universal prescriptivism is a recently developed moral decision-making theory that combines utilitarian and Kantian theories with two levels of moral thinking. A combined approach offers a creative solution to the weaknesses inherent in traditional moral theories. The paper describes the theory and discusses important implications for nursing education, practical ethical decision-making, and research. The relationship of an ethical theory of caring to traditional moral theory is discussed.

Decision Making↗

PubMed2004

Comparative study of perceptions of work environment and moral sensitivity among Japanese and Norwegian nurses.

The aim of the present study was to explore the relationship between work environment and moral sensitivity among Japanese (n = 138) and Norwegian nurses (n = 71), and to compare the results from a sociocultural perspective using a descriptive-correlational design. Data were analyzed using descriptive and inferential statistics. The results point to a significant relationship between work environment and moral sensitivity for both groups of nurses. In comparison, the Japanese nurses were more focused on 'patient centered oriented care', reported 'work engagement', seeking 'meaning in difficult caring situations' and 'following rules'. In addition, they ranked the factor 'values in action of patient care' as significant and 'relation to superior and colleagues' and 'job stress and anxiety' ranked significant to 'moral conflicts'. The Norwegian nurses were more independent, which was correlated with moderate significance with 'job stress and anxiety'. A significant correlation was found between 'physical and mental symptoms' and 'moral conflicts' among Norwegian nurses.

Adult↗

PubMed2005

Hypnotic disgust makes moral judgments more severe.

Highly hypnotizable participants were given a posthypnotic suggestion to feel a flash of disgust whenever they read an arbitrary word. They were then asked to rate moral transgressions described in vignettes that either did or did not include the disgust-inducing word. Two studies show that moral judgments can be made more severe by the presence of a flash of disgust. These findings suggest that moral judgments may be grounded in affectively laden moral intuitions.

Emotions↗

PubMed1975

The development of moral judgments concerning capital punishment.

Data from a 20-year longitudinal study of the development of moral judgment in American males indicate that the most mature stages evince moral condemnation of the death penalty. The authors conclude that American moral standards are evolving towards a view of execution as unjust punishment. They contend that a theory of punishment based on the highest stage of moral reasoning is more valid than lower-stage justifications for capital punishment, and that it provides a rational basis for asserting the immorality--and unconstitutionality--of capital punishment, irrespective of uncertainties as to the deterrent efficacy of the death penalty.

Adolescent↗

PubMed2006

Washing away your sins: threatened morality and physical cleansing.

Physical cleansing has been a focal element in religious ceremonies for thousands of years. The prevalence of this practice suggests a psychological association between bodily purity and moral purity. In three studies, we explored what we call the "Macbeth effect"-that is, a threat to one's moral purity induces the need to cleanse oneself. This effect revealed itself through an increased mental accessibility of cleansing-related concepts, a greater desire for cleansing products, and a greater likelihood of taking antiseptic wipes. Furthermore, we showed that physical cleansing alleviates the upsetting consequences of unethical behavior and reduces threats to one's moral self-image. Daily hygiene routines such as washing hands, as simple and benign as they might seem, can deliver a powerful antidote to threatened morality, enabling people to truly wash away their sins.

Emotions↗

PubMed1985

The moral significance of spontaneous abortion.

Spontaneous abortion is rarely addressed in moral evaluations of abortion. Indeed, 'abortion' is virtually always taken to mean only induced abortion. After a brief review of medical aspects of spontaneous abortion, I attempt to articulate the moral implications of spontaneous abortion for the two poles of the abortion debate, the strong pro-abortion and the strong anti-abortion positions. I claim that spontaneous abortion has no moral relevance for strict pro-abortion positions but that the high incidence of spontaneous abortion is not (as some claim) eo ipso any sort of justification for voluntarily induced abortion. Secondly, I show that if the strict anti-abortionist position is to be taken seriously in its insistence that prenatal life has a right to be protected by virtue of its being conceived, then it seems necessary to take measures to prevent spontaneous abortion and its presumptive causes, and this as a matter of moral obligation.

Abortion, Spontaneous↗

PubMed2006

Are patients morally responsible for their errors?

Amid neglect of patients' contribution to error has been a failure to ask whether patients are morally responsible for their errors. This paper aims to help answer this question and so define a worthy response to the errors. Recent work on medical errors has emphasised system deficiencies and discouraged finding people to blame. We scrutinize this approach from an incompatibilist, agent causation position and draw on Hart's taxonomy of four senses of moral responsibility: role responsibility; capacity responsibility; causal responsibility; and liability responsibility. Each sense is shown to contribute to an overall theoretical judgment as to whether patients are morally responsible for their errors (and success in avoiding them). Though how to weight the senses is unclear, patients appear to be morally responsible for the avoidable errors they make, contribute to or can influence.

Causality↗

PubMed2002

Analogy in moral deliberation: the role of imagination and theory in ethics.

This paper develops themes addressed in an article by Eric Wiland in the Journal of Medical Ethics 2000;26:466-8, where he aims to contribute to the debate concerning the moral status of abortion, and to emphasise the importance of analogies in moral argument. In the present paper I try to secure more firmly a novel understanding of why analogy is an essential component in the attempt to justify moral beliefs. I seek to show how analogical argument both encapsulates and exercises the notions of rationality and imagination and that the construction, development, and comparison of analogies fundamentally underpins ethical argument. In so doing, it enables us to adopt imaginative and ethically illuminating perspectives but in a manner that does not relinquish any claims to intellectual rigour. I present a critique of a brand of "moral particularism" by showing how it cannot, if construed in a certain way, adequately conceive of how we use analogies and imaginary cases in ethics. Although such a particularism is thus impotent with regard to ethical debate, I show that the wider motivation behind particularism that can be extracted is of clear relevance and importance to medical practitioners.

Abortion, Induced↗

PubMed2004

Human embryo research and the language of moral uncertainty.

In bioethics as in the sciences, enormous discussions often concern the very small. Central to public debate over emerging reproductive and regenerative biotechnologies is the question of the moral status of the human embryo. Because news media have played a prominent role in framing the vocabulary of the debate, this study surveyed the use of language reporting on human embryo research in news articles spanning a two-year period. Terminology that devalued moral status-for example, the descriptors things, property, tissue, or experimental material -was found to outnumber fivefold those that affirmed any degree of moral status above that of inanimate cellular matter; for example, living, human life, or human being. A quarter of the articles failed to note that the embryos under discussion were human. These findings confirm that even among scientific and philosophical experts a diversity of opinion exists on society's moral obligations to nascent human life. The skewed linguistic distribution also indicates a distinct bias. Concerned readers should take notice when any category of humanity becomes subject to prejudicial and disparaging language and the value of vulnerable human life is trivialized alongside sensational assertions of anticipated medical cures. The responsibility for holding the media to a higher standard of truth and fairness falls to us all.

Beginning of Human Life↗

PubMed1998

"Healthy avenues of the mind": psychological theory building and the influence of religion during the era of moral treatment.

OBJECTIVE: This article delineates the main psychological interventions used by American asylum superintendents practicing moral treatment between 1815 and 1875. Further, it explores the impact of Protestant religious ideas on specific aspects of moral treatment's theory and practice. METHOD: Asylum annual reports written by superintendents (physicians dedicated to the treatment of the mentally ill) were studied along with volumes of the American Journal of Insanity from its premier issue in 1844 through the 1890s. The writings of two laymen, Thomas Gallaudet and Horace Mann, both committed advocates of moral treatment, were also examined. RESULTS: The superintendents espoused complex theories about individual psychology and the nature of the self based on their observations. Protestant religious thought was a major influence, helping to catalyze original psychological propositions. Interesting resonances can be found between the superintendents' concept of a central agency, a governing "I" accounting for individual behavior, and ego psychologists' concepts of the organizing functions of the ego. CONCLUSIONS: Moral treatment did not produce a comprehensive psychotherapeutic system. Nonetheless, the superintendents voiced surprisingly modern psychotherapeutic insights. Religious worship as well as religious notions about the inviolability of the soul greatly influenced their views of patients. Rather than being an impediment to formulating psychological ideas, religious concepts proved to be a rich framework for evolving theories about aspects of patients' internal psychological functioning.

Christianity↗

PubMed2006

Moral reckoning in nursing.

Analysis of qualitative data resulted in an original substantive grounded theory of moral reckoning in nursing, a three-stage process. After a novice period, the nurse experiences a stage of ease in which there is comfort in the workplace and congruence of internal and external values. Unexpectedly, a situational bind occurs in which the nurse's core beliefs come into irreconcilable conflict with external forces. This compels the nurse into the stage of resolution, in which he or she either gives up or makes a stand. The nurse then moves into the stage of reflection in which he or she lives with the consequences and iteratively examines beliefs, values, and actions. The nurse tries to make sense of experiences through remembering, telling the story, and examining conflicts. This study sets the stage for further investigation of moral distress. The theory of moral reckoning challenges nurses to tell their stories, examine conflicts, and participate as partners in moral decision making.

Attitude of Health Personnel↗

PubMed2004

Moritz Benedikt's (1835-1920) localization of morality in the occipital lobes: origin and background of a controversial hypothesis.

During the 1870s the Austro-Hungarian neuropsychiatrist Moritz Benedikt (1835-1920) proposed a remarkable neurological localization of morality in the human brain. More precisely, he thought of the ultimate parts of the occipital lobes as the seat of the moral sense. The so-called non-coverage of the cerebellum that was discovered in apes and criminals underpinned his localization. This paper studies the origin, background and reception of Benedikt's unique but opiniated localization of human morality. It is argued that his self-labelling as a freethinker offers the most understandable reason why Benedikt looked so eagerly for the seat of the moral sense in the human brain and why he was ultimately bold enough to suggest a cerebral localization.

Austria↗

PubMed1995

The influence of gender, education and experience on moral sensitivity in psychiatric nursing: a pilot study.

The purpose of this study was to investigate some factors which may influence moral decision-making in psychiatric nursing practice. The Moral Sensitivity Questionnaire, a 30-item, seven-point Likert scale, measures six dimensions that are assumed to be related to moral sensitivity. In scoring, the test is divided into six categories: interpersonal orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing conflict, and reliance on medical authority. Seventy-nine nurses, employed in the same psychiatric district, were included in the sample. Significant differences were found for some items in five of the six categories regarding gender, post-basic nursing education, experience as a mental care worker and type of clinical setting.

Adult↗