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PubMed1990

Information about morality and behaviour of victims.

According to the Italian Law of Procedure (1988) documents which inform about the morality of the guilty, the witness and the victim are not admitted; those about the victim are admitted only when the criminal event needs to be evaluated in relation to his/her behaviour and moral qualities. In our opinion, in this case, generic moral qualities do not have any real significance; only information about the victim's objective behaviour should be admitted: for instance, in the case of the crime of "corruption of a minor", a type of objective behaviour can be habitual prostitution. Moreover, the norm at issue contrasts with the general principle in the Italian law that the rights concerning the personality of an individual, particularly of a minor, are to be protected, and with the fundamental norm in the law of Procedure according to which criminological examinations are not allowed during the trial. It is useful, however, to acquire elements in order to evaluate the credibility of the witness.

Behavior↗
PubMed1990

The pharmacotherapy of moral or religious scrupulosity.

Moral or religious scrupulosity is a disabling condition which is sometimes seen in patients with obsessive compulsive disorder (OCD). The authors described 10 patients with moral or religious scrupulosity who were treated with fluoxetine or clomipramine. Seven of the 10 patients completed open treatment of at least 8 weeks without requiring adjunctive medication; 5 of those 7 patients were rated as much improved. Among the 3 patients who required adjunctive medication, 1 was rated as much improved. Of the 4 nonresponders at 3 months, 2 responded after longer treatment trials. These results suggest that extreme moral or religious concerns and behaviors might be a form of OCD and that the scrupulosity can be effectively treated with serotonin reuptake blockers.

Adolescent↗
PubMed1990

Sources of moral authority: what is right?

This variety of rightness--the end, the means, personal moral development--is a reminder of the need for tolerance of several "right" actions. Again, it is a balance between viewpoints, between concern for the individual and the rights of society. Tolerance is a major aspect of American history--tolerance for a variety of religious traditions, tolerance for a variety of ethnic and cultural traditions, tolerance for a variety of interpretations (values) of life and its meaning. We grow up with variety in religious beliefs, values, ethical principles, or theories (ethical pluralism). We also function at varying levels of moral development at different times, which influences our choice of what is right or good in nursing care. The variety of "right" actions can be confusing. We know firsthand the complexity of trying to choose among several morally right actions, one of which is in the best interests of the neonate and his family. This is the challenge of modern neonatal care. This is the challenge of bioethical decision making. This is the challenge for ethical nursing practice.

Decision Making↗
PubMed1985

Moral thinking and government policy: the Warnock Committee on Human Embryology.

A parliamentary committee of inquiry was convened in response to growing concern--among the general public and the scientific community--about new techniques in human fertilization and research in embryology. The committee had to enter that jurisprudential minefield, the theoretical relation between morality and the law. When issues arise in which there is no historical tradition, the voice of morality may be genuinely confused and uncertain. But the law, unlike moral opinion, cannot be contradictory; it must be definite, unambiguous, and universally applicable.

Advisory Committees↗
PubMed1984

Lying and killing: language and the moral reasoning of twelve- and fifteen-year-olds by social group.

Twenty groups of children of different social class, ethnic, national and regional backgrounds were matched by non-verbal reasoning ability and school experience. Their moral stances on "lying" and "killing" and their reasons for those stances were recorded orally on a one-to-one basis, using a school setting conducive to concentration and uninhibited communication. Individual literacy levels had no influence on results. There was an impressive consistency in moral attitudes and in reasons offered for those attitudes across children of quite different social backgrounds. There was also a very common access to higher level, autonomous reasoning among the adolescents surveyed. A strong link between moral development and language development can be inferred from the findings, but the parallel is not clear cut.

Adolescent↗
PubMed1984

[Ethical principles and moral norms of psychiatric care in a socialistic society].

Ethical postulates, which are intended to serve as orientation points for personal conduct, must be formulated clearly as demands, be related to the system of values on which they are based, and point out clearly the consequences of their being ignored and must therefore be connected with moral bans. The authors have tried to formulate such postulates for the most important ethical problems facing psychiatry in the GDR. These moral guidelines, which naturally infer moral bans, offer fuel for discussion as one step towards the establishment of a comprehensive code of ethics for psychiatrists.

Ethics, Medical↗
PubMed1980

Promoting postconventional morality: the adequacy of Kohlberg's aim.

Lawrence Kohlberg has advocated the implementation of programs in the public schools designed to raise the general level of moral reasoning. His contention is that the attainment of Postconventional moral reasoning is associated with optimal personal and social adjustment. Growing concern about the violence and disintegration of American society has led to public and private support for such programs. Because intervention into the moral education of children in a democratic society raises serious social/political questions, it seems appropriate to consider the relevance of the Kohlberg hypothesis. In this paper, the twin issues of philosophic adequacy and empirical evidence are examined. In neither respect does the cognitive-developmentalist position find the support essential to a recommendation for its use.

Adaptation, Psychological↗
PubMed1993

Ethical and moral dilemmas in the treatment of an abusive parent--the occupational therapy perspective.

Treating patients who physically abuse their children creates in the therapist moral and ethical dilemmas which challenge his or her ability to maintain a professional conduct and attitude. In such cases the therapist usually finds himself or herself confronted with the following dilemmas: (a) treatment of a patient who experiences therapy as a no-choice situation; (b) treatment of a patient whose conduct is in conflict with the moral values of the therapist; (c) the obligation of the therapist to report the abusive acts to the authorities versus his or her duty to protect the patient's right to confidentiality; and (d) the therapist's loyalty to the patient's welfare, when it is in conflict with the abused person's welfare. These issues are illustrated through the following case study examined in the context of occupational therapy (OT): A 26-year-old married woman, mother to a four-month-old infant was referred to therapy after causing severe burns to her daughter's hands. As a child the patient experienced physical abuse by her parents. The patient viewed treatment as her only possible means of keeping her child. On the other hand, she was suspicious of verbal therapy, as she assumed that the contents might incriminate her. Occupational therapy was therefore a major therapeutic modality used to assess and improve her disturbed psychosocial occupational performances. The article describes the way in which the OT approach helped overcome and resolve the moral and ethical dilemmas raised in the case.

Adult↗
PubMed1993

Alberta euthanasia survey: 1. Physicians' opinions about the morality and legalization of active euthanasia.

OBJECTIVE: To ascertain the opinions of a sample of Alberta physicians about the morality and legalization of active euthanasia, the determinants of these opinions and the frequency and sources of requests for assistance in active euthanasia. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through July 1991; usable responses were returned by 1391 (69%). RESULTS: Of the respondents 44% did believe that it is sometimes right to practice active euthanasia; 46% did not. Moral acceptance of active euthanasia correlated with type of practice and religious affiliation and activity. In all, 28% of the physicians stated that they would practice active euthanasia if it were legalized, and 51% indicated that they would not. These opinions were significantly related to sex, religious affiliation and activity, and country of graduation. Just over half (51%) of the respondents stated that the law should be changed to permit patients to request active euthanasia. Requests (usually from patients) were reportedly received by 19% of the physicians, 78% of whom received fewer than five. CONCLUSIONS: This survey revealed severely disparate opinions among Alberta physicians about the morality of active euthanasia. In particular, religious affiliation and activity were associated with the polarized opinions. The desire for active euthanasia, as inferred from requests by patients, was not frequent. Overall, there was no strong support expressed by the physicians for the personal practice of legalized active euthanasia. These data will be vital to those involved in health education and public policy formation about active euthanasia in Alberta and the rest of Canada.

Alberta↗
PubMed1997

Maintaining good morale in old age.

Traditional aging studies have seen life's later years as a time of inevitable biological and social decline. Psychological decline might also be expected, but this is not true for most older people, according to epidemiologic studies. Thus, we must ask: Why is aging not as emotionally threatening as might be expected? Why do some older people do better than others? How should medicine address these issues? It is only possible to understand the successful emotional aging of most elders if the customary diathesis-stress model is supplemented by a developmental perspective. Expectations as well as capacities diminish with aging. This means that subjective health appears more tightly linked with morale than objective health. Some older people experience recurrence of mental disorders (for example, major depression) first present earlier in life. Others experience new disorders such as minor depression in response to biological or social losses. As geriatric medicine comes to increasingly focus on chronic disease, attention to morale is an important strategy for maximizing quality of life. Physicians will need improved skills in the detection and treatment of problems in morale if they are to provide optimum care for their older patients.

Adaptation, Psychological↗
PubMed1997

Measuring morale--does practice area deprivation affect doctors' well-being?

BACKGROUND: Morale is a perennial concern in general practice and, over the years, a variety of tools have been used to examine doctors' mental well-being in a range of psychological and sociological studies. Despite perceived associations between low morale and practice area deprivation, this has not been investigated previously. AIM: To devise and apply a measure of mental well-being in general practitioners, and to use this to investigate the effect of practice area deprivation. METHOD: A questionnaire was devised and piloted, then used in an anonymous postal survey of a random sample of 500 London general practitioners, with questions on demography, workload, practice characteristics, patient centredness, and practice area deprivation. RESULTS: A total of 334 (68%) doctors replied to the questionnaire. Of these, 45% often feel exhausted, 46% are often frustrated by trivial consultations, and a third are seriously disenchanted with work. The resulting well-being score had a normal distribution, was reproducible (test-retest reliability = 0.91), and was internally consistent (Cronbach's alpha = 0.76). Comments from respondents suggested good face validity. Low well-being was not associated with practice area deprivation, but was associated with time stress, small practices and primary care teams, and lack of patient centredness. CONCLUSION: The instrument provided a useful tool for examining doctors' well-being and the associations thereof. Well-being was not associated with practice area deprivation. Help for small primary care teams and measures to reduce time stress should help to improve morale.

Catchment Area, Health↗
PubMed1993

The Castillo-Morales approach to orofacial pathology in Down syndrome.

Infants with Down syndrome often present with a familiar orofacial disorder which exists at birth or becomes more pronounced by the end of the first year. The primary pathology includes hypotonicity of the perioral muscles, lips, and masticatory muscles and a protruding tongue, later followed by active tongue protrusion. This results in problems with sucking, swallowing, drooling and dentition. Early intervention methods employing the combination of Castillo-Morales Manual Orofacial Therapy and his specially designed palatal plate, can improve orofacial function, facial appearance and prevent secondary conditions like pseudoprognathism, dental diseases, malocclusions, open mouth habit and pseudomacroglossia. This retrospective study examines the outcome of therapy, as prescribed by Castillo-Morales, in 39 children with Down syndrome. Normally, the average age to begin oral therapy is between six to eight months. The children were treated with the Castillo-Morales Manual Orofacial Therapy and his palatal plate for an average of 17.9 months. In this study, clinical evaluations at the beginning and the end of therapy focused only on open mouth posture and tongue protrusion. In addition, the direct stimulating effect of the palatal plate on tongue protrusion was evaluated. Significant positive results were observed in all three areas.

Child, Preschool↗
PubMed1998

The effectiveness of guided design on ethical decision making and moral reasoning among community nursing students.

This study evaluated the effectiveness of guided design as an instructional method in ethical decision making and moral reasoning among 145 community health nursing students. Changes in the process of ethical decision making and moral reasoning were measured using Ketefian's judgment About Nursing Decisions (JAND) one week after the intervention. Results indicated a significant difference in ethical decision-making scores after instruction, but no difference in moral reasoning. The one specific component--Taking professional initiatives--increased on both subscales.

Community Health Nursing↗
PubMed1996

The controversy over retrospective moral judgment.

The mandate of the U.S. Advisory Committee on Human Radiation Experiments required that the Committee take a position on the validity of retrospective moral judgments. However, throughout its period of operation, the Committee remained divided on the question of whether sound judgments of individual culpability and wrongdoing should be included in its Final Report. This essay examines the arguments that various committee members marshalled to support their opposing views on retrospective moral judgment and explains the significance of the controversy.

Advisory Committees↗
PubMed1993

Slang 'on board'. A moral analysis of medical jargon.

Medical jargon is commonly used by health-care professionals. The use of such jargon is sometimes criticized as insensitive or callous. Rather than generalize, we identify four basic types of medical jargon and discuss their relevant moral distinctions. Our characterizations of jargon include medical acronyms, euphemisms, and initiatory and derogatory language. Physicians should be aware of the ways in which they use medical slang. Jargon can serve useful purposes but its moral status is often dependent on the function it serves and the context in which it is used. Jargon that is clearly derogatory can reflect negatively on the moral character of the medical profession and should be avoided when possible.

Humans↗
PubMed2006

Are there morally acceptable alternatives to blastocyst derived ESC?

ESC derivation, use and SCNT have raised many moral and ethical issues. In this opinion piece I have focused on the argument that morally less ambiguous alternatives to ESC derived from the ICM of blastocysts exist. These possibilities range from using multiple adult stem cell populations each of which is uniquely suited for a particular disease target or identifying adult ESC-like populations, using transdifferentiated ESC-like cells or alternate methods of deriving ESC. I suggest that while it is important to support such efforts, current results do not provide sufficient compelling data to allow one to stop the use of ESC and perhaps adult cells will never be a reliable alternative. All options need to be fully explored and decisions need to be made with scientific rigor and respect for each individual's moral compass.

Aging↗
PubMed2006

The moral difference between intragenic and transgenic modification of plants.

Public policy on the development and use of genetically modified organisms (GMOs) has mainly been concerned with defining proper strategies of risk management. However, surveys and focus group interviews show that although lay people are concerned with risks, they also emphasize that genetic modification is ethically questionable in itself. Many people feel that this technology "tampers with nature" in an unacceptable manner. This is often identified as an objection to the crossing of species borders in producing transgenic organisms. Most scientists reject these opinions as based on insufficient knowledge about biotechnology, the concept of species, and nature in general. Some recent projects of genetic modification aim to accommodate the above mentioned concerns by altering the expression of endogenous genes rather than introducing genes from other species. There can be good scientific reasons for this approach, in addition to strategic reasons related to greater public acceptability. But are there also moral reasons for choosing intragenic rather than transgenic modification? I suggest three interrelated moral reasons for giving priority to intragenic modification. First, we should respect the opinions of lay people even when their view is contrary to scientific consensus; they express an alternative world-view, not scientific ignorance. Second, staying within species borders by strengthening endogenous traits reduces the risks and scientific uncertainty. Third, we should show respect for nature as a complex system of laws and interconnections that we cannot fully control. The main moral reason for intragenic modification, in our view, is the need to respect the "otherness" of nature.

Community Participation↗
PubMed2000

An analysis of moral issues affecting patenting inventions in the life sciences: a European perspective.

Following the 1980 US Supreme Court decision to allow a patent on a living organism, debate has continued on the moral issues involved in biotechnology patents of many kinds and remains a contentious issue for those opposed to the use of biotechnology in industry and agriculture. Attitudes to patenting in the life sciences, including those of the research scientists themselves, are analysed. The relevance of morality to patent law is discussed here in an international context with particular reference to the law of the European Patent Convention administered by the European Patent Office (EPO). The EPO has been the principal forum for opposition to such patents and the few cases under dispute in the EPO are reviewed, including patents for the onco-mouse, human relaxin gene, and the PGS herbicidally resistant plant (gmo). Morality provisions in the European Parliament and Council Directive 98/44/EC are also summarised.

Animals↗