Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MORALS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed2001

Neonatal euthanasia: moral considerations and criminal liability.

Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice.

Child Abuse↗
PubMed2002

Reproductive tourism as moral pluralism in motion.

Reproductive tourism is the travelling by candidate service recipients from one institution, jurisdiction, or country where treatment is not available to another institution, jurisdiction, or country where they can obtain the kind of medically assisted reproduction they desire. The more widespread this phenomenon, the louder the call for international measures to stop these movements. Three possible solutions are discussed: internal moral pluralism, coerced conformity, and international harmonisation. The position is defended that allowing reproductive tourism is a form of tolerance that prevents the frontal clash between the majority who imposes its view and the minority who claim to have a moral right to some medical service. Reproductive tourism is moral pluralism realised by moving across legal borders. As such, this pragmatic solution presupposes legal diversity.

Abortion, Illegal↗
PubMed2003

A virtue ethics approach to moral dilemmas in medicine.

Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine.

Adult↗
PubMedDate not supplied

Framing the decision: determinants of how women considering multifetal pregnancy reduction as a pregnancy-management strategy frame their moral dilemma.

OBJECTIVE: How people make decisions regarding medical technologies and procedures are affected by how they 'frame' those decisions. Medical frames are characterized by a reliance on statistics regarding outcomes and risk to mother and surviving embryos, emphasize the influence of medical authorities, and are driven by a desire to minimize medical risks. Moral frames, on the other hand, are driven more by a desire to minimize the disruption to antiabortion and antireduction moral precepts, and weight heavily the advice of religious leaders. These frames contest with one another. Our objective is to examine the biographical determinants of frame dominance in this contest as it applies to multigestation pregnancies where selective reduction is being considered as a pregnancy-management strategy. METHODS: For a sample of 55 multigestation women considering multifetal reduction as a pregnancy-management strategy, we develop a distinction between medical and moral frames. Semistructured interviews generated qualitative data that were independently coded by two researchers. These variables were then analyzed using dummy variable regression analysis. RESULTS: Conceptualizing these frames as anchoring opposite ends of a continuum, we show that 40% of the variance in frame dominance can be accounted for by three factors: how involved patients are in religious institutions that have antiabortion norms, whether they have medico-scientific careers, and how pro-reduction their advice has been from fertility specialists and obstetricians prior to coming to the clinic. CONCLUSIONS: The implication of these results for practice include recognizing the wide variation in patient's perceptions of their situations and how these perceptual frames alter how women confront risk-benefit statistics and being flexible in one's approach to counseling patients. This approach can further serve as a model for similar reproductive-health dilemmas.

Career Choice↗
PubMed2002

Stem cell research: a target article collection: Part III--determining moral status.

In this chapter, I review some of the background thinking concerning matters of moral status that I had developed in previous years and that I would now bring to the work of the Human Embryo Research Panel. Two ideas were at the forefront of my thinking. First, that biology usually offers not decisive "events" but only continuous processes of development. Second, in making status determinations we do not so much "identify" a point on a developmental continuum where moral respect should be accorded as "choose" that point. These choices are "balancing decisions" in which the community of moral agents weighs its interests in protecting an entity against the burdens of doing so. After illustrating these two contentions, I consider some of the reasons why thinkers on the "right" and "left" of our bioethics debates have resisted or missed this basic insight.

Abortion, Induced↗
PubMed2004

Self-preservation: an argument for therapeutic cloning, and a strategy for fostering respect for moral integrity.

The issues of human cloning and stem cell retrieval are inseparable in circumstances in which the rationale of self-preservation may be invoked as a negative right. I apply this rationale to a hypothetical case in which cloning is necessary to preserve the bodily integrity or life of an individual. Self-preservation as moral integrity is examined in a narrower context, i.e., as applicable to those for whom deliberate termination of embryonic life is morally-problematic. This issue is addressed through comparison with two paradigms commonly used in support of clinical practice: the distinction between letting die and killing, and the permissibility of vital organ retrieval after death. Although these paradigms are questionable in their own right, they offer a rationale by which scientists and clinicians may respect the negative right to moral integrity of those with whom they disagree.

Beginning of Human Life↗
PubMed2003

"... As you would have them do unto you": Does imagining yourself in the other's place stimulate moral action?

Philosophers, psychologists, and religious teachers have suggested that imagining yourself in another's place will stimulate moral action. The authors tested this idea in two different situations. In Experiment 1, participants had the opportunity to assign themselves and another research participant to tasks, with one task clearly more desirable than the other. Imagining oneself in the other's place did little to increase the morality (fairness) of the decision. A different form of perspective taking, imagining the other's feelings, increased direct assignment of the other to the desirable task, apparently due to increased empathy. In Experiment 2, participants confronted a different decision: either accept an initial task assignment that would give them highly positive consequences and the other participant nothing or change the assignment so they and the other would each receive moderately positive consequences. In this situation, imagining oneself in the other's place did significantly increase moral action.

Adult↗
PubMed1977

Responses to moral dilemmas in medical students and psychiatric residents.

There has been an increasing interest in the area of medical ethics as indicated not only by the recent proliferation of books and articles but also in the re-emergence of crucial moral issues such as euthanasia, abortion and the like. The difficulty with the existing literature is that these reports are often descriptive, anecdotal and situationally relative to the decision maker. In this study, the authors utilized a cognitive developmental approach to studying responses to moral situations not only because this approach is cross-culturally universal but also because it is not subject to situational variables. In this regard, the results of the assessment of medical students and psychiatric residents are presented as well as a comparison of moral reasoning stages in relation to the C.M.A. Code of Ethics. Recommendations for further research are presented.

Codes of Ethics↗
PubMed2006

The role of conflict resolution styles on nursing staff morale, burnout, and job satisfaction in long-term care.

This study focuses on the ability of nursing staff to interact with residents in a way that affects positively on the nurses' well-being and occupational satisfaction. It investigates the role of coping skills related to staff-resident interactions, in particular, the use of conflict resolution styles and their influence on the level of morale, burnout and job satisfaction of nursing professionals. A self-administered questionnaire was used to collect information from 161 direct care nursing staff. The authors used a multiple regression procedure to examine the influence of predictors on nursing staff outcomes. Multivariate analyses indicated that nurses' psychological morale, occupational stress, and job satisfaction are influenced by conflict resolution styles, after controlling by individual characteristics, work demands, and work resources factors. The findings highlight the importance of considering personal coping abilities to foster positive staff-resident interactions and to increase nurses' morale and job satisfaction.

Adaptation, Psychological↗
PubMed1995

Gender differences in moral reasoning among physicians, registered nurses and enrolled nurses engaged in geriatric and surgical care.

Physicians, registered nurses (RNs) and enrolled nurses (ENs) engaged in geriatric (n = 49) and surgical (n = 59) care at a large hospital in Sweden gave 180 accounts of morally difficult care episodes. In total, the ENs (n = 40) gave 78, the RNs (n = 38) 55 and the physicians (n = 30) 47 accounts; there were 83 from geriatric care and 97 from surgical care. Forty-nine participants were male, and 59 were female; there were no differences in gender in the form and content of the moral reasoning disclosed in either morally difficult care episodes or in the complete interviews when coded as mainly narrative or propositional, or as showing a care or a justice orientation. The ENs showed a care orientation, while RNs and physicians, to an equal degree, showed both a justice and a care orientation. The ENs also used narrative reasoning more often than RNs and physicians. No differences were seen between the two health care specialties.

Ethical Analysis↗
PubMed2006

Understanding the moral distress of nurses witnessing medically futile care.

PURPOSE/OBJECTIVES: To explore the topic of moral distress in nurses related to witnessing futile care. DATA SOURCES: Literature related to moral distress and futility; analysis of narratives written by 108 nurses attending one of two national continuing education courses on end-of-life care regarding their experiences in the area. DATA SYNTHESIS: Nurses were invited to share a clinical situation in which they experienced moral distress related to a patient receiving care that they considered futile. Nurses described clinical situations across care settings, with the most common conflict being that aggressive care denies palliative care. Conflicts regarding code status, life support, and nutrition also were common. Patients with cancer were involved quite often, second only to geriatric patients and patients with dementia. The instances created strong emotional responses from nurses, including feeling the need for patient advocacy and that futile care was violent and cruel. Important spiritual and religious factors were cited as influencing the clinical experiences. CONCLUSIONS: Instances of futile care evoke strong emotional responses from nurses, and nurses require support in dealing with their distress. IMPLICATIONS FOR NURSING: The ethical dilemma of futile care is complex. Additional research and support are needed for patients, families, and nurses.

Humans↗
PubMed2002

Stories from the operating room: moral dilemmas for nurses.

This article explores stories related by perioperative nurses when asked to describe ethical judgements and subsequent actions that affected patient outcomes. A total of 214 patient care situations were analysed for moral actions taken and moral outcomes achieved in the perioperative arena. Content analysis of the patient care situations revealed a wide variety of ethical issues. Concerns about informed consent and quality of care were the most frequently identified issues. Respondents reported that 7% of patients underwent unwanted procedures and that positive moral outcomes were achieved in 65% of situations. It is of concern that, despite the fact that more than two-thirds (69%) of the respondents reported undergoing ethics education, only 27% could relate a story of an ethical situation.

Attitude of Health Personnel↗
PubMed2005

Nurses and national socialism--a moral dilemma: one historical example of a route to euthanasia.

If euthanasia were to be made legal in other countries apart from The Netherlands and Belgium, nurses would be faced with ethical dilemmas that could impact on their professional accountability and their personal moral beliefs. As a part of history has demonstrated, the introduction of the practice of euthanasia could also significantly change the relationship between nurses and patients. In Germany between 1940 and 1945, in response to a government directive, nurses participated in the practice of euthanasia and as a result many innocent German people were killed by what were considered to be 'mercy deaths'. It is important to try and understand the moral thinking and examine the complex issues at this historical junction that led German nurses to participate in the killing of thousands of innocent people. Such reflection may help to stimulate an awareness of the moral issues that nurses in the twenty-first century could confront if euthanasia were to be made legal in their own country. This has implications for future nursing practice.

Attitude of Health Personnel↗
PubMed2005

Experience of dealing with moral responsibility as a mother with cancer.

This study explored how women with a diagnosis of cancer (lymphoma) deal with moral concerns related to their responsibility as parents. Ten women with cancer and who had children living at home were interviewed. The interviews were analysed according to the constant comparative method used in grounded theory. In order to provide a focus for the analysis, the ethics of care and the concept of mothering were used as sensitizing concepts. The core concept 'experience of dealing with moral responsibility of being a parent with cancer by redefining oneself as a mother was identified. The processes involved were: interrupted mothering; facing the life-threatening illness and children's reactions; striving to be a good mother; attempting to deal with moral responsibility; and coming to terms with being a mother.

Adaptation, Psychological↗
PubMed2006

Constructing a morality of caring: codes and values in Australian carer discourse.

In this analysis I apply a Foucauldian approach to ethics to examine the politically prescribed moral and ethical character required of carers of aged persons at home in Australia and the role of nurses in shaping these behaviours. The work that spousal carers provide, although often founded on love and/or obligation, has been formalized through a variety of policy initiatives and technologies that serve to construct the moral approach they must adopt. This shaping of conduct at the most personal level takes place through the application of codes of behaviour policed largely by nurses. These codes redefine the mode of coexistence between an aged husband and wife and propose a new form of relationship that is derived from and supports policies of the deinstitutionalization of care services for elderly persons. In this way modern carer policy has drawn on knowledge and governance of the self to produce a morality of caring that is both authoritative and scientific.

Aged↗
PubMed2006

Moral deliberation in psychiatric nursing practice.

Moral deliberation has been receiving more attention in nursing ethics. Several ethical conversation models have been developed. This article explores the feasibility of the so-called CARE (Considerations, Actions, Reasons, Experiences) model as a framework for moral deliberation in psychiatric nursing practice. This model was used in combination with narrative and dialogical approaches to foster discourse between various stakeholders about coercion in a closed admission clinic in a mental hospital in the Netherlands. The findings demonstrate that the CARE model provides a substantial framework for structuring moral deliberations. Narratives and dialogue are useful tools for broadening issues in conversations, to engage various stakeholders (including patients), and to gain shared understandings.

Attitude of Health Personnel↗
PubMed2005

Weighing both sides: morality, mortality, and framing contests over obesity.

Despite recent and growing media attention surrounding obesity in the United States, the so-called obesity epidemic remains a highly contested scientific and social fact. This article examines the contemporary obesity debate through systematic examination of the claims and claimants involved in the controversy. We argue that four primary groups-antiobesity researchers, antiobesity activists, fat acceptance researchers, and fat acceptance activists-are at the forefront of this controversy and that these groups are fundamentally engaged in framing contests over the nature and consequences of excess body weight. While members of the fat acceptance groups embrace a body diversity frame, presenting fatness as a natural and largely inevitable form of diversity, members of the antiobesity camp frame higher weights as risky behavior akin to smoking, implying that body weight is under personal control and that people have a moral and medical responsibility to manage their weight. Both groups sometimes frame obesity as an illness, which limits blame by suggesting that weight is biologically or genetically determined but simultaneously stigmatizes fat bodies as diseased. While the antiobesity camp frames obesity as an epidemic to increase public attention, fat acceptance activists argue that concern over obesity is distracting attention from a host of more important health issues for fat Americans. We examine the strategies claimants use to establish their own credibility or discredit their opponents, and explain how the fat acceptance movement has exploited structural opportunities and cultural resources created by AIDS activism and feminism to wield some influence over U.S. public health approaches. We conclude that notions of morality play a central role in the controversy over obesity, as in many medical disputes, and illustrate how medical arguments about body weight can be used to stymie rights claims and justify morality-based fears.

Attitude to Health↗
PubMed1987

Moral reflections on the new technologies: a Catholic analysis.

New technologies of conception bring into being beautiful babies. The wonder of these children, and of the technologies themselves, can tempt us to abbreviate ethical reflection on the moral appropriateness of initiating human life in this way. However, the moralists of the Catholic Church, along with many others, judge that human life should originate in acts of love between parents, not in productive acts of technologists. Scientific help for people desiring to generate a child out of their own being should be distinguished from scientific substitution for human acts of love in originating life. The child must be recognized as an equal, not as a product, subject to quality control. To radically alter our ways of generating human life without sufficient moral reflection is to generate human pain and moral dilemmas that we have not begun to fathom.

Catholicism↗