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PubMed2002

Ego development and the ethics of care and justice: the relations among them revisited.

This study examined the links among ego development and the ethics of care and justice in 144 Norwegian men and women, 15 to 48 years old, taking into consideration age, sex, education, and verbal intelligence. As expected, the relationship between Loevinger's model of ego development and care-based moral reasoning as measured with Skoe's Ethic of Care Interview (ECI) was significantly stronger than the one between ego development and justice as measured with Rest's Defining Issues Test (DIT). Both ethics correlated significantly with verbal ability. Analyses showed that beyond its overlap with verbal intelligence, the variance shared between the ECI and ego development was substantial. By contrast, when verbal intelligence was controlled, the DIT was not significantly related to ego development or to the care ethic.

Adolescent↗
PubMed2001

Caring in nursing: a different interpretation.

AIM: To apply Habermas' (1995) Theory of Moral Consciousness and Communicative Action to the nurse-patient relationship, offering a different interpretation to the nurse-patient relationship that is caring in nursing. RATIONALE: Many authors have described the nurse-patient relationship, but Habermas' theory synthesizes the components into a complex matrix that is caring in nursing. FINDINGS: The theory offers three claims to normative validity: the claim to truth which is the factual objective knowledge; the claim to truthfulness which refers to the intrasubjective self; and the claim to right which is the intersubjective interaction. The validity claims explain the patient's personal and illness self, the nurse's personal and professional self, and the interaction/discourse. The interaction is situation specific, and is identified as moral because dialogue/discourse requires a 'considerateness' of each for the other. 'Considerateness' in discourse requires certain rules, including that each participant has an equal voice, be followed in order for the Principle of Universalization to occur. Habermas draws on Kohlberg's (1981), and Selman's (1980) work to develop three levels of moral maturity of communication. These are preconventional, conventional, and postconventional. Initial moral maturity is egocentric, subjective, and obedient to authority. Maturity develops with recognition of other and reciprocity. At the postconventional level there is mutuality and the ability for abstract reasoning. There is a third person objectivity combining speaker and addressee/listener perspectives. Norms are not just accepted, they are reasoned through. This leads to justification of the norm, which is then accepted as valid. When the three validity claims are met and there is genuine 'considerateness' in the interaction there is communicative action. The reverse is strategic action, where the communication is coercive. When there is communicative action both patient and nurse are validated with a sense of fulfillment or . CONCLUSION: Habermas' (1995) theory offers a new paradigm for caring in nursing.

Consciousness↗
PubMed2004

Applying critical thinking skills to character education and values clarification with students who are deaf or hard of hearing.

Students who are deaf or hard of hearing must learn to think critically. Character education (CE) refers to the effort to teach basic values and moral reasoning (Doyle & Ponder, 1977). Values clarification (VC) is the process of examining one's basic values and moral reasoning (Rokeach, 1973). Character education and values clarification as subject matter foster the development of critical thinking (CT), a tool used both to develop and to modify values and moral reasoning. These three areas mutually support one another. The development of a set of values and their underlying moral reasoning is the foundation for thinking critically about values. The authors examine the components of critical thinking, character education, and values clarification, summarize the literature, and provide a template for appropriate lesson plans. They also describe strategies that promote the development of critical thinking, character education, and values clarification.

Character↗
PubMed1992

Future use and development of prenatal diagnosis. Consumers' attitudes.

The rapid progress of prenatal diagnosis and genetic tests makes it important to investigate attitudes towards this development. A total of 40 women and 20 men with personal experience of prenatal diagnosis for chromosome aberrations were interviewed about their moral opinion of the development. The majority (88 per cent) considered it certain or probable that all new methods developed will also be used in the future. The majority (62 per cent) were hesitant about testing for common disorders, e.g., diabetes mellitus and rheumatoid arthritis, but regarded it justified in some situations. One-third of the individuals (31 per cent) wanted some kind of restrictions for the use of the tests, but only 13 per cent recommended legislation for this purpose. The majority (84 per cent) believed that ethical principles are influenced by scientific progress. In most aspects, the women and their partners had similar attitudes. However, 82 per cent of the women but only 20 per cent of the men considered that the couple itself should decide about prenatal diagnosis. The results demonstrated a considerable respect regarding the difficult choices associated with the development of prenatal diagnosis, also among those who have decided favour of the test. The study indicated a greater need for autonomy among women than among men.

Adult↗
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↗
PubMed1989

Moral beliefs of physicians, medical students, clergy, and lay public concerning AIDS.

A questionnaire was developed to assess religiously based moral beliefs about acquired immunodeficiency syndrome. The questionnaire was administered to a group of primarily black physicians, a selection of freshman medical students, two groups of clergy representing contrasting philosophical orientations, a group of young urban black and white attendees of a black cultural event, and two groups of older whites from rural Tennessee who were attending health fairs. Other attitudes about acquired immunodeficiency syndrome and related issues were also assessed. Results showed that 40% to 70% of rural whites strongly endorsed the idea that acquired immunodeficiency syndrome is a product of "divine intervention" or "divine retribution." More than half attributed the epidemic to a fulfillment of biblical prophecy. Two of five conservative clergy strongly agreed with the idea of divine intervention, whereas only one in 20 liberal clergy concurred. Approximately one in 10 physicians endorsed these propositions. The responses of freshman medical students were strikingly similar to those of physicians, except that less than half as many believed acquired immunodeficiency syndrome represents the fulfillment of a biblical prophecy. Physicians were remarkably similar to rural whites and conservative clergy in their distrust of the experts concerning the potential contagion of human immunodeficiency virus. When responses to several key items on the questionnaire were combined to create a measure of "conservatism," mean total scores differentiated all groups in the manner predicted. We conclude that religiously based moral beliefs about acquired immunodeficiency syndrome can have dangerous implications for the treatment of its victims by society and its caregivers.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1997

Doing the right thing: relief agencies, moral dilemmas and responsibility in political emergencies and war.

In recent years a new generation of relief workers and relief agencies has become embroiled in the heat of civil wars and political emergencies, and the humanitarian community has had to revisit its fundamental principles and address the ethics of what it does. This paper sets out to continue this important debate by emphasising that ethical analysis should always be an essential part of humanitarian practice. The paper seeks to recognise the difficult moral choices relief agencies are facing today and gives some practical guidelines to relief agency staff when confronting the ethics of a given situation. In particular, it hopes to introduce some ethical principles into the debate about humanitarianism and contribute to the moral vocabulary which is being developed to improve relief agencies' ethical analysis. The paper starts by looking at the essential characteristics of a moral dilemma, and the way in which other types of tough choice can masquerade as moral dilemmas. It then introduces some basic moral principles surrounding the key ethical notions of action consequences and moral responsibility in an effort to show how relief agencies might begin to develop a process of ethical analysis in their work. Finally, it explores how relief agencies might develop a more intuitive form of ethical analysis based on an organisational conscience and moral role models.

Decision Making↗
PubMed2006

Measuring moral distress in pharmacy and clinical practice.

This article presents the development, validation and application of an instrument to measure everyday moral distress in different health care settings. The concept of moral distress has been discussed and developed over 20 years. A few instruments have been developed to measure it, predominantly in nursing. The instrument presented here consists of two factors: level of moral distress, and tolerance/openness towards moral dilemmas. It was tested in four medical departments and three pharmacies, where 259 staff members completed a questionnaire. The two factors were found to be reliable. Differences in levels of moral distress were found between pharmacies and clinical departments, and between the youngest and oldest age groups; departmental staff and the youngest group experienced higher levels of moral distress. Departments reported less tolerance/openness towards moral dilemmas than pharmacies. The instrument needs to be tested further, but its strengths are the focus on everyday ethical dilemmas and its usefulness in different health care settings.

Adaptation, Psychological↗
PubMed2003

The ethics of public consultation in health care: an Orthodox Jewish perspective.

New Zealand and United Kingdom governments have set new directives for increased consultation with the public about health care. Set against a legacy of modest success with past engagement with public consultations, this paper considers potentially adverse ethical implications of the new directives. Drawing on experiences from New Zealand and the United Kingdom, and on an Orthodox Jewish perspective, the paper seeks to answer two questions: What conditions can compromise the ethics of public consultation? How can the public respond ethically to consultation? In answering these questions, the paper considers how Orthodox Judaism, as a specific positive morality, can aid the development of public policy. It is suggested that an Orthodox Jewish perspective does not require limiting the content of public consultations and helps to define a common procedural morality binding Jews and non-Jews. This procedural morality requires avoiding two conditions that, as shown from Jewish texts, make public consultation unethical. These are "overpreparation" and "underpreparation." Members of the public who deem a consultation unethical should give feedback not on the proposal but on the conditions they perceive to prevent the consulting party from considering their viewpoints on the proposal.

Community Participation↗
PubMed2006

Children's conscience and self-regulation.

We focus on children's conscience, an inner guiding system responsible for the gradual emergence and maintenance of self-regulation. Drawing from our research program that has encompassed three large longitudinal studies cumulatively covering the first 6 years of life, we discuss two major components of conscience: moral emotions (guilt, discomfort following transgressions) and moral conduct compatible with rules and standards. We discuss the organization of young children's conscience, focusing on relations between moral emotions and moral conduct, and the development of conscience, focusing on its early form: the child's eager, willing stance toward parental socialization. We also review research on two major sets of influences that predict individual differences in moral emotions and moral conduct: biologically based temperament and socialization in the family. We discuss two inhibitory systems of temperament-fearfulness and effortful control-and several features of socialization, including the style of parental discipline and the quality of the parent-child relationship. Early conscience is an important early personality system, coherently organized, relatively stable over time, and subject to individual differences that emerge as a result of a complex interplay between children's temperamental individuality and socialization in the family.

Child↗
PubMed1989

The adolescent as forgiver.

A social cognitive developmental model of forgiveness is described and tested in two studies, the second being a replication of the first. In study 1, 59 subjects in grades 4, 7, 10, college and in adulthood were given a forgiveness interview that assessed six stages of forgiveness development, Rest's DIT measure of justice development, and a religiosity scale. As predicted, there were strong age trends for forgiveness and justice. Both forgiveness and justice were related but distinct constructs. The more one practiced one's faith, the higher one was in forgiveness stage. Study 2, with 60 subjects, replicated the above findings. The studies give strong evidence that people's understanding of forgiveness develops with age. Implications for adolescent development are drawn.

Adolescent↗