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PubMedDate not supplied

The use of service learning in client environments to enhance ethical reasoning in students.

OBJECTIVES: This study examined the effects of two service-learning experiences on the psychosocial and moral reasoning development of occupational therapy students. The assumption was that ethical reasoning ability can be facilitated through participation in value-laden experiences. METHOD: Participants visited older adults in nursing homes (n = 19) or interacted with persons with disabilities in community settings (n = 33). All participants reflected on their experiences through weekly journals. Psychosocial and moral reasoning development were measured at the beginning and end of the experiences with the Student Development Task and Lifestyle Inventory and the Sociomoral Reflection Measure-Short Form. RESULTS: Participants in both groups exhibited a significant time-related increase in psychosocial development but no increase in moral reasoning. Participants interacting with persons with disabilities exhibited a decrease over time in moral reasoning compared with the participants interacting with older adults. CONCLUSION: Service learning effected a change in the participants' psychosocial development indicative of developing an appreciation for dignity, equality, and justice. These are core concepts in occupational therapy and are viewed as important in ethical reasoning. The lack of advancement and current level of moral reasoning in these undergraduate students raises a question as to their readiness to engage in ethical reasoning as entry-level practitioners.

Activities of Daily Living↗
PubMedDate not supplied

Antifoundationalism and the possibility of a moral philosophy of medicine.

The problem of developing a moral philosophy of medicine is explored in this essay. Among the challenges posed to this development are the general mistrust of moral philosophy and philosophy in general created by post-modernist philosophical and even anti-philosophical thinking. This reaction to philosophical systematization is usually called antifoundationalism. I distinguish different forms of antifoundationalism, showing that not all forms of their opposites, foundationalism, are alike, especially with regards to claims made about the certitude of moral thought. I conclude that we are correct to mistrust absolutist principles in a moral philosophy of medicine, but can find some center within the practice of medicine itself for a moral foundation.

Cultural Diversity↗
PubMed1995

Developmental issues influencing guidelines for adolescent health research: a review.

Adolescent development brings many opportunities to adolescents as research participants. They may be enthusiastic participants, especially if the focus of the research is of interest to the adolescents. Their increasing sense of self and development of autonomy may yield open, thoughtful responses less likely with older research participants. At the same time, the researcher must be aware of particular vulnerabilities of adolescents. Cognitive and reasoning capacity emerges gradually over the adolescent decade, making younger adolescents less capable than older adolescents of effective reasoning. The researcher can adjust materials to be understandable to the younger adolescent but should also recognize that inexperience could increase anxiety or emotionality about an issue not problematic to an older adolescent or adult. Making clear the right of the adolescent to refuse to discuss particular issues usually permits more honest responses, and increases the likelihood of consent to research or parts of research. Especially stressful circumstances may cause degradation of reasoning capacity suggesting that the researcher needs to assess whether the adolescent is able to make a wise decision about participation, as well as about particular responses. The researcher can usually identify ways to alleviate stress in the study situation and should take all steps necessary to obtain both informed consent and valid responses. Existing research provides clear evidence that most adolescents, at least past age 14 or 15 years, are able to function as well as adults research participants under most circumstances. With younger adolescents and under stressful situations, the researcher can find ways to minimize risk from research and increase the likelihood of valid responses.

Adolescent↗
PubMed1987

A model for ethical problem solving in medicine, with practical applications.

Despite the dramatic increase over recent years in the research and teaching of medical ethics, there exists no theoretical framework within which to conceptualize ethical problems in medicine, to say nothing of solutions to these problems. The model proposed here attempts to fill this void by developing a conceptual understanding of the nature of moral dilemmas that can be applied to both theoretical and practical problems in medicine. Practical applications are demonstrated in three areas: personal ethical problem solving, hospital ethics committees, and the teaching of medical ethics. Suggestions are offered for the extension of these and other applications of the model, a model proposed as a foundation to be built upon through further research and daily experiences in a world of conflicting values.

Bioethical Issues↗
PubMed2003

Indicators of children's development: considerations when constructing a set of national Child Health Indicators for the European Union.

BACKGROUND: In a recent project, commissioned by the European Union, a set of Child Health Indicators were identified and recommended for use in all Member States. In that work, by a group of European experts, children's development was one of the key areas that were reviewed to clarify its role in this set of indicators. This paper deals with neurological (in a broad sense), social and moral aspects of development; other aspects, such as nutrition and physical growth, mental health, quality of life were dealt with in other areas. METHODS: A number of methods are used to monitor children's neurodevelopment, to identify early deviations that could be treated or alleviated. Few tests fulfil basic criteria of screening and quality of evidence. For Child Health Programmes, developmental surveillance is instead recommended. As a proxy to social development, as part of children's process of adaptation into society, education indicators are recommended, such as suggested by OECD and UNICEF. Moral development is discarded as an indicator, because norms and values vary too much between countries. CONCLUSION: For now the Child Health Indicators of Life and Development Project found no ground to recommend any particular method or combination of methods for a general monitoring of children's neurological, intellectual, language and moral development, and for including the results as national indicators of children's health and well-being in EU. For social development, indicators in the educational area seem most promising, as they have been proposed and used by OECD and UNESCO. In an ambitious monitoring programme, these indicators could be included as determinants of children's health and development.

Adaptation, Psychological↗
PubMedDate not supplied

Academic dishonesty among nursing students.

Student cheating on college campuses is believed to be a common occurrence, but academic dishonesty among nursing students is a source of legitimate concern to nursing faculty members because of its potential effect on present and future professional practice. Strategies are outlined that can promote academic honesty in the nursing program through moral and character development of nursing students, teaching moral decision-making skills, role-modeling of honest academic behavior, and developing and enforcing an appropriate academic integrity policy.

Character↗
PubMed2003

Changes in the components of moral reasoning during students' medical education: a pilot study.

INTRODUCTION: Many authors are concerned by students' moral reasoning not developing normally during medical education. AIM: This study is concerned with how the components of student' moral reasoning are affected by their medical studies. METHODS: Ninety-two medical students were tested on entry into first year and on finishing third year, to determine evolutionary changes in their moral reasoning. Changes in their use of arguments specific to each stage of moral development were measured. RESULTS: Significant changes were observed in the weighted global score (-18.14 +/- 59.17, P = 2.8%). Changes in global score correlated with changes in stages of moral reasoning. The multivariate structure of moral reasoning was reorganised into two principal components, which, respectively, explained almost 82% (first year) and 72% (third year) of the total variability in scores. Moral reasoning stages characterized by law-and-order and social-contract/legalistic orientations proved important for explaining the variability in students' moral reasoning at the start of medical training, while instrumental-relativist and interpersonal-concordance orientations explained variability post third year. CONCLUSIONS: Students restructure their handling of ethical questions by using arguments with more instrumental-relativist and interpersonal-concordance orientations, rather than those of the more desirable law-and-order or social-contract/legalistic type. To assess better the skills required for moral reasoning, a more sophisticated approach is needed than that of a simple measure of improvement/stagnation/deterioration.

Adult↗
PubMed1990

The value of an oath of professional conduct: process, content, or both?

...I would suggest that the major objectives of studying the Hippocratic Oath or other pertinent oaths and codes are fourfold. First, studying oaths and codes pertaining to medical conduct and standards enables students to learn about historical changes and cultural influences. Second, choosing an oath or developing one for recitation at graduation enables students to engage in conceptual and moral reasoning. Third, the deliberations and discussions involving students enable them to practice interactional, communication skills about highly charged issues. Fourth, the identified limitations of the Hippocratic Oath or other pertinent oaths and codes enable students to appreciate the value of the broader principles that support medical ethics... The remainder of this commentary is divided into two parts. In the first part, recommendations for an educational program are presented. In the second part, recommendations for future research in this area are offered.

Codes of Ethics↗
PubMed2004

Teaching engineering ethics to first-year college students.

One of the methods used at Penn State to teach engineering students about ethics is a one-credit First-Year Seminar entitled "How Good Engineers Solve Tough Problems." Students meet in class once a week to understand ethical frameworks, develop ethical problem-solving skills, and to better understand the professional responsibilities of engineers. Emphasis is on the ubiquity of ethical problems in professional engineering. A learning objective is the development of moral imagination, similar to the development of technical imagination in engineering design courses. Making sound arguments is also addressed in the process of reasoning through cases, and critiquing other's arguments. Over the course of the semester, students solve five engineering ethics cases. Each week, a student team of four people is responsible for reading the assigned section of the text, developing a summary, and leading the class discussion.

Engineering↗
PubMed2001

Developing drugs for the developing world: an economic, legal, moral, and political dilemma.

This paper discusses the economic, legal, moral, and political difficulties in developing drugs for the developing world. It argues that large, global pharmaceutical companies have social responsibilities to the developing world, and that they may exercise these responsibilities by investing in research and development related to diseases that affect developing nations, offering discounts on drug prices, and initiating drug giveaways. However, these social responsibilities are not absolute requirements and may be balanced against other obligations and commitments in light of economic, social, legal, political, and other conditions. How a company decides to exercise its social responsibilities to the developing world depends on (1) the prospects for a reasonable profit and (2) the prospects for a productive business environment. Developing nations can either help or hinder the pharmaceutical industry's efforts to exercise social responsibility through various policies and practices. To insure that companies can make a reasonable profit, developing nations should honor pharmaceutical product patents and adhere to international intellectual property treaties, such as the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement. To insure the companies have a good business environment, developing nations should try to promote the rule of law, ethical business practices, stable currencies, reliable banking systems, free and open markets, democracy, and other conditions conducive to business. Overall, this paper advocates for reciprocity and cooperation between pharmaceutical companies and developing nations to address the problem of developing drugs for the developing world. In pursuing this cooperative approach, developing nations may use a variety of other techniques to encourage pharmaceutical companies to act responsibly, such as subsidizing pharmaceutical research, helping to design and implement research protocols, providing a guaranteed market, and bulk buying.

Beneficence↗
PubMed2000

Moral responsibility and respect for autonomy: meeting the communitarian challenge.

The principle of respect for autonomy has come under increasing attack both within health care ethics, specifically, and as part of the more general communitarian challenge to predominantly liberal values. This paper will demonstrate the importance of respect for autonomy for the social practice of assigning moral responsibility and for the development of moral responsibility as a virtue. Guided by this virtue, the responsible exercise of autonomy may provide a much-needed connection between the individual and the community.

Bioethics↗
PubMed1992

In the genes or in the stars? Children's competence to consent.

Children's competence to refuse or consent to medical treatment or surgery tends to be discussed in terms of the child's ability or maturity. This paper argues that the social context also powerfully influences the child's capacity to consent. Inner attributes and external influences are discussed using an analogy of the genes and the stars.

Adolescent↗
PubMed2002

The West's moral obligation to assist developing nations in the fight against HIV/AIDS.

The HIV/AIDS epidemic is increasingly a disease of the disadvantaged, a destroyer of nations, and a threat to global security and well-being. But this need not be so: the world has the scientific knowledge, technological innovations, and financial resources to significantly reduce the spread and suffering caused by the disease. This paper argues that the wealthy nations of the world, led by the United States, have a moral obligation to offer much greater assistance to developing countries where the epidemic is most severe. Using Zimbabwe as a case study, this essay examines the immediate and underlying factors behind the epidemic in order to make realistic and affordable policy recommendations that include new investments in global health care, debt relief, and long-term economic development. By demonstrating our ability to dramatically affect the future course and consequences of this unprecedented epidemic, the paper concludes that greater action is not only in the interest of public health, but is also a moral imperative. By investing the necessary resources to improve public health and to reduce global poverty, we promote and extend the fundamental rights and values that we profess to hold dear.

Communicable Disease Control↗
PubMed2004

Religion as a resource for positive youth development: religion, social capital, and moral outcomes.

Although existing literature demonstrates that developmental benefits are associated with religion for adolescents, little is understood about the dynamics of this relationship. Drawing on social capital theory, this study tested a conceptual model exploring socially embedded religious influences on moral outcomes. A three-dimensional model of social capital demonstrated how social interaction, trust, and shared vision enable social ties associated with religiousness to influence moral behavior. Structural equation modeling was used with data gathered from 735 urban youths to test a proposed model of the effects of religiousness on moral outcomes. Results suggested that religiously active youths report higher levels of social capital resources and that the influence of adolescent religiousness on moral outcomes was mediated through social capital resources. Suggestions for further research and implications for faith-based youth development organizations are considered.

Adolescent↗