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PubMed2000

Legislation on ethical issues: towards an interactive paradigm.

In this article, we sketch a new approach to law and ethics. The traditional paradigm, exemplified in the debate on liberal moralism, becomes increasingly inadequate. Its basic assumptions are that there are clear moral norms of positive or critical morality, and that making statutory norms is an effective methods to have citizens conform to those norms. However, for many ethical issues that are on the legislative agenda, e.g. with respect to bioethics and anti-discrimination law, the moral norms are controversial, vague or still evolving. Moreover, law proves not to be a very effective instrument. Therefore, we need a new paradigm, both for descriptive and for normative analysis. This interactive paradigm, as a normative position, can be summarised in two theses. The process of legislation on ethical issues should be structured as a process of interaction between the legislature and society, or relevant sectors of society, so that the development of new moral norms and the development of new legal norms may reinforce each other. And legislation on ethical issues should be designed in such a way that it is an effective form of communication which, moreover, facilitates an ongoing moral debate and an ongoing reflection of such issues, because this is the best method to ensure that the practice remains oriented to the ideals and values the law tries to realise.

Animal Care Committees↗
PubMed1989

Values, moral reasoning, and ethics.

The purpose of this exchange was to explore the domains of values, moral reasoning, and ethics. Values and moral reasoning reflect the "is." Moral reasoning is the mental process that nurses set in motion to come to some decision of right or wrong in any moral dilemma. Values are motivational preferences or dispositions. Moral values are those preferences that are integral to any moral reasoning process. Ethics reflect the oughts. It is the art-science that critically evaluates the "is." As such, ethics identifies the norms or standards of behaviors that either are or can become the values that are implemented through moral reasoning. Nursing is just beginning to identify its moral values and reasoning. Nevertheless, nursing seems to be further along in the identification of the "is" than it is with the "ought." The further development of nursing ethics will be of great benefit to nurse researchers and educators. The greatest benefit will be, however, to the practicing nurse as she/he struggles with giving excellent nursing care consistent with a positive nursing ethic.

Beneficence↗
PubMed1993

The development of a measure of job satisfaction for use in monitoring the morale of community nurses in four trusts.

The development of the Measure of Job Satisfaction (MJS) for use in a longitudinal study of the morale of community nurses in four trusts is described. The review of previous studies focuses on the use of principal component analysis or factor analysis in the development of measures. The MJS was developed from a bank of items culled from the literature and from discussions with key informants. It was mailed to a one in three sample of 723 members of the community nursing forums of the Royal College of Nursing. A 72% response rate was obtained from those eligible for inclusion. Principal component analysis with varimax rotation led to the identification of five dimensions of job satisfaction; Personal Satisfaction, Satisfaction with Workload, Satisfaction with Professional Support, Satisfaction with Pay and Prospects and Satisfaction with Training. These factors form the basis of five subscales of satisfaction which summate to give an Overall Job Satisfaction score. Internal consistency, test-retest reliability, concurrent and discriminatory validity were assessed and were found to be satisfactory. The factor structure was replicated using data obtained from the first three of the community trusts involved in the main study. The limitations of the study and issues which require further exploration are identified and discussed.

Career Mobility↗
PubMed2004

Ethical practice in nursing: working the in-betweens.

BACKGROUND: While contemporary ethical theory is of tremendous value to nursing, the extent to which such theory has been informed by the concerns and practices of nurses has been limited. PURPOSE: With a view to complementing extant ethical theory, a study was undertaken to explore, from the perspective of nurses, the meaning of ethics and the enactment of ethical practice in nursing. DESIGN AND METHODS: Located in the interpretive/constructivist paradigm, using an emergent design, this inquiry employed focus groups to collect the data. Eighty-seven nurses from a wide range of practice settings were interviewed in 19 focus groups of three to nine nurses each. FINDINGS: The nurses described ethics in their practice as both a way of being and a process of enactment. They described drawing on a wide range of sources of moral knowledge in a dynamic process of developing awareness of themselves as moral agents. Enacting moral agency involved working in a shifting moral context, and working in-between their own values and those of the organizations in which they worked, in-between their own values and those of others, and in-between competing values and interests. CONCLUSIONS: Analysis of the experiences and concerns of the nurses offered new understanding of ethics in nursing and direction for the development of ethical theory pertinent to nursing practice.

Adult↗
PubMed1988

Biological processes and moral events.

It is often argued that the continuity of the processes of embryo development precludes the establishment of morally significant boundaries, once development is under way. These arguments typically claim that marking out any moral boundaries requires identifying particular significant events, and that in such circumstances this is either impossible or arbitrary. In this paper it is argued that arguments of this kind are not cogent. The paper concludes by indicating where the real problems lie.

Beginning of Human Life↗
PubMed2004

Moral professional personhood: ethical reflections during initial clinical encounters in nursing education.

Moral agency is an important constituent of the nursing role. We explored issues of ethical development in Greek nursing students during clinical practice at the beginning of their studies. Specifically, we aimed to explore students' lived experience of ethics, and their perceptions and understanding of encountered ethical conflicts through phenomenological analysis of written narratives. The process of developing an awareness of personal values through empathizing with patients was identified as the core theme of the students' experience. Six more common themes were identified. Development of the students' moral awareness was conceptualized as a set of stages, commencing with empathizing with patients and nurses, moving on to taking a moral stand and, finally, concluding by becoming aware of their personal values and showing evidence of an emerging professional moral personhood. The notions of empathy, caring and emotion were in evidence throughout the students' experience. Implications for practice and nurse education are discussed.

Adult↗
PubMed1992

The political and moral economy of aging: not such strange bedfellows.

The authors develop E.P. Thompson's concept of moral economy as a useful complement to contemporary political economic analysis in problem areas involving moral conflict. Defined as the shared assumptions underlying norms of reciprocity in which an economic system is grounded, moral economy is seen as holding particular relevance for the study of aging. The evolution of pension systems, the "senior revolt" against catastrophic coverage in the United States, and debates over the allocation of health resources between generations are used to illustrate the utility of a combined political and moral economy for enriching our understanding in these areas. Marx's concept of a "morality of emancipation" is described as holding particular promise for the development of a new moral economy of old age that would move beyond alienation by giving broad attention to quality of life issues at each stage of the life course.

Aged↗
PubMed1986

A psychoanalytic approach to ethics.

The paper addresses some of the problems of the relationship between ethics and psychology. Philosophical assumptions which are considered are shown to bear directly on the source of the conviction that one ought to behave in some particular way. The choice of an "empirical" ethic, i.e., an epistomology which rests on psychology, is perceived to be a confusing pseudo-scientific error, which has developed in response to increasing guilt. Guilt is seen to play a central role in the evolution of the superego and the self, considered from both an ontological and and phylogenetic basis. These problems, first presented in Civilization and Its Discontents (Freud, 1930), are considered from the standpoint of what is known about normal superego development, the influence of social and historical forces on such development, and pathological superego development. The Kantian assumption of a transcendent moral authority is shown to be related to the earliest symbiotic unity of mother and child, in the context of the first internalized constraints on the aggressive and libidinal drives. The burden of such constraints is seen to be guilt, increasingly less tolerable through the interaction of social, historical, and psychological influences. The response to this guilt is a major influence in the denial of a transcendent moral authority, and the shift toward fewer constraints on the drives. The more obvious social and political consequences are considered.

Aggression↗
PubMed2002

The 'morality' of occupational health.

Both ethics and law are based on value systems. George Lakoff has contributed to our understanding of the value systems that influence attitudes toward public issues in his book, Moral Politics: What Conservatives Know That Liberals Don't (University of Chicago Press, 1996). He argues that two antagonistic but co-existing moral systems influence attitudes toward public issues. Both are derived from metaphors of family life and child development and the "morality" of allowing certain actions. One moral system stresses individual responsibility and risk-taking, the other empathy and mutual assistance. The tension between these value systems explains much in political debate; issues generally tend to fall on one side or the other. Occupational health and related issues, almost uniquely, have the unfortunate characteristic of falling short in both. Our best efforts may be judged "immoral" by the strictest interpretations of both systems, even when they are successful. The practical implication is that we must not accept this pattern of thinking. The work relationship is not like a family. It is important to separate issues in occupational health from this pattern of thinking in both professional and public discourse.

Journal Article↗
PubMed2002

Moral conflict as a component of ordinary worry.

This article contributes to the psychology of moral behavior by inquiring into the presence and extent of worrying about moral concerns in one's life relative to worrying about practical concerns. A 20-item questionnaire was developed, mixing eight moral worry questions with twelve ordinary worry items (finances, health) identified in previous research on worry. Factor analysis produced three domains of worrisome thinking: moral concerns, social desirability, and personal and family health. A single item inquiring into worry about not living up to God's expectations did not load onto any other factor and was dropped from further analysis. Internal consistency for the moral worry factor scale was .85. Mean scores for this scale (moral domain) were significantly lower than mean scores for the two practical worry domain factors. Limitations of the study and directions for further research are outlined.

Adolescent↗
PubMed2003

Emotional responses to antisocial acts in adolescent males with conduct disorder: a link to affective morality.

Examined the role of emotion-based moral processes in the committing of delinquent acts by adolescent males with conduct disorder (CD). An Affective Morality Index (AMI) was developed to assess emotional responses to vignettes of delinquent acts. CD groups, as compared to a non-CD group, reported lower levels of guilt and fear and higher levels of excitement and happiness following described transgressions. Number of CD symptoms and a recidivism-risk item were correlated negatively with reported guilt and fear and positively with happiness and excitement. Trends suggested that youth with childhood-onset CD (CO) show lower levels of affective morality than those with adolescent-onset CD (AO). There were no effects for anger. This research, and in particular the AMI, expands our understanding of affective-based morality, especially in discriminating between CD and non-CD youth.

Adolescent↗