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At least 1,099 records · Page 61Linked to original sources
PubMed1997

A model for conceptualizing the moral dynamic in health care.

Ethics involves an organized, reasoned approach to gathering and processing data in order to arrive at decisions about what to do, what to value, and/or what virtues to cultivate. A model is proposed for conceptualizing this complex dynamic, which incorporates elements of both rule-and-principle ethics and the ethic of care. The model suggested here has two levels. The first level identifies the components that comprise philosophical reasoning; the second contextualizes and operationalizes the model in relation to the processor's philosophical stance on the nature of knowing. Three philosophical stances are identified and described: science-dominant, person-dominant, and science-person equilibrium. Physicians tend to process patients from first perspectives, nurses from second. Hence, health team collaboration in moral problem solving is critically important.

Bioethical Issues↗
PubMed1991

The moral status of animals and their use in research: a philosophical review.

In this article I offer a philosophical review of (1) leading theories of the moral status of animals, (2) pivotal theoretical issues on which more progress needs to be made, and (3) applications to the setting of animal research. Such an examination demonstrates, I believe, that the practical implications of leading theories converge far more than might be expected. In addition, I hope this review helps to clarify particularly troubling issues that remain so they can be treated adequately.

Animal Experimentation↗
PubMed2002

Poor working conditions and the capacity of nurses to provide moral care.

The capacity of nurses to uphold exemplary standards of care is being increasingly compromised by the poor conditions under which they are expected to work. Historically nurses have somehow managed to provide ethical and therapeutically effective care to patients even when circumstances have pressured them to do otherwise. There is, however, a limit to what nurses can endure - and to what it is reasonable to expect them to endure - when working in environments that are hostile to moral excellence. Social justice demands that the 'nurse question' be re-examined with a view toward challenging and changing the status quo.

Beneficence↗
PubMed1991

Ethics education or moral persuasion?

The question, "What is virtue and how can it be taught?" has been with us for quite a while. H. Steven Moffic, John Coverdale, and Timothy Bayer address it in a particular setting -- psychiatric practice -- with a particular group of students -- GY-III residents -- and employ a particular strategy -- a seminar... The course sounds like a good one -- wide ranging, open minded, and relevant to students' interests and experiences. I am less convinced than they are that education in ethics leads to moral behavior, but nonetheless I share their belief that it belongs in the curriculum... The authors are right to emphasize that ethical issues go beyond the doctor-patient relationship and include the profession-society interface as well.

Education, Medical↗
PubMedDate not supplied

The moral costs of the Ontario physicians' strike.

In a strike to permit extra billing, physicians in Ontario, Canada, sought to balance their concerns for professional autonomy with their primary call to beneficence. But the right to reasonable compensation within a nationalized health care system is not on the same moral plane as the public's right to health care. Having failed to convince either the provincial government or the public of the soundness of their position, Ontario's doctors must now repair the damage done to the relationship with their patients.

Economics, Medical↗
PubMed1996

Community psychiatric care: from libertarianism to coercion. Moral panic and mental health policy in Britain.

This article discusses recent developments in mental health policy in Britain, focusing on the move towards compulsory supervision of mentally ill people in the community. It is argued that the desire for compulsion reflects moral panic rather than rational appraisal of the undoubted problems with community mental health care. Alternative strategies involving education of the patient and cares, the deployment of psychological treatments of psychosis and an emphasis on the negotiation of treatment plans, are advocated.

Coercion↗
PubMed1979

Dimensions of moral character and drug use among rural high school students.

Related major parameters of moral character (socialization and empathy) identified by Hogan (1973) to self-reported drug use in a sample of 88 rural high school students. As expected, level of socialization correlated significantly with total drugs used, frequency of marijuana use, and number of drug-related social complications. However, at variance with past research of college students, empathy did not relate to any of the drug-use variables examined. It was speculated that the implications of characterological factors for drug use may vary with age of the user.

Adolescent↗
PubMed2005

I wish the hour were over: elements of a moral dilemma.

In contrast to the viewpoint that sees conflict as deriving from defense against instinctual drives and thus as an intrapsychic phenomenon, this essay presents conflict as sometimes being an external opposition between disparate configurations of the self. These parallel sectors with different goals and ambitions can be seen in a continuum from the dramatic narcissistic behavior disorders to more subtle instances of moral dilemmas. A clinical illustration is offered to demonstrate its occurrence and management in psychoanalysis.

Conflict, Psychological↗
PubMed2002

Moral education for the elite of democracy: the classe de philosophie between sociology and philosophy.

In this article, I address the issues at stake in the relationship between sociology and philosophy in the second half of the nineteenth century by focusing on a debate between two parties: Emile Durkheim, who was attempting to found an independent scientific sociology, and the editors and collaborators of the Revue de métaphysique et de morale (RMM), one of the central philosophical journals of the period. This debate focused on the role of philosophy in secondary school education, but at its heart, this was a struggle between two disciplines over which ought to direct the formation of good citizens for Third Republic France.

Democracy↗
PubMed1989

Moral reasoning among medical geneticists in eighteen nations.

We surveyed the approaches of 661 geneticists in 18 nations to 14 clinical cases and asked them to give their ethical reasons for choosing these approaches. Patient autonomy was the dominant value in clinical decision-making, with 59% of responses, followed by non-maleficence (20%), beneficence (11%) and justice (5%). In all, 39% described the consequences of their actions, 26% mentioned conflicts of interest between different parties and 72% placed patient welfare above the welfare of others. The U.S., Canada, Sweden, and U.K. led in responses favoring autonomy. There were substantial international differences in moral reasoning. Gender differences in responses reflected women's greater attention to relationships and supported feminist ethical theories.

Asia↗
PubMed1982

Behavioral disordered children's conceptions of moral, conventional, and personal issues.

This study employed a series of sorting tasks with 22 normal and 20 children with behavioral disorders (BD) to determine whether BD children discriminate among three classes of social actions viewed by normal children as distinct. These categories are (1) the moral (actions having intrinsic effects upon the rights or well-being of others), (2) the conventional (actions whose propriety is determined by social consensus), and (3) the personal (actions whose propriety is a matter of individual prerogative). Findings were that although BD children distinguished among the three forms of behavior, they differed with normals in the classifications of specific acts and in the reasons given for act classifications. Chief among these differences was the finding that BD children were less likely than normals to identify acts as within their personal domain.

Child↗
PubMedDate not supplied

The context as a moral rule in medical ethics.

A purely deductive medical ethics cannot properly account for the varieties of circumstances which arise in medical practice. By contrast, a purely inductive medical ethics lacks sufficient guidance from ethical principles. In resolving ethical dilemmas in medicine, most often an appeal is made to middle-level axioms and methodological rules to mediate between theory and practice. I argue that this appeal must be augmented by considerations of context, such considerations, in effect, constituting a moral rule based on the social structure of medical practice. A contextual grid is proposed which assists the process of weighing values in resolving cases.

Bioethical Issues↗
PubMed1994

The idea of the absurd and the moral decision. Possibilities and limits of a physician's actions in the view of the absurd.

In reference to two central concepts of Albert Camus' philosophy, that is, the absurd and the rebellion, this article examines to what extent his The Plague is of interest to medical ethics. The interpretation of this novel put forward in this article focuses on the main character of the novel, the physician Dr. Rieux. For Rieux, the plague epidemic, as it is described in the novel, implies an unquestioning commitment to his patients and fellow men. According to Camus this epidemic has to be understood as a symbol of the absurd. Unable to base his actions on a Christian, metaphysical value system, Rieux sees his commitment as a continuous rebellion against the fact of the absurd, which opposes him in the form of evil, suffering and death. As a physician, Rieux is therefore forced to adjust his actions to life in its immediacy, that is, the suffering of his patients. In this article, it will be shown that Rieux's attention to the "immediate" is of particular interest to medical ethics: The other person in need, rather than my moral convictions, sets the norm.

Attitude to Death↗
PubMed1995

Contesting the natural in Japan: moral dilemmas and technologies of dying.

The paper opens with a discussion about the recognition of "whole-brain death" as the end of life in North America in order to perform solid organ transplants. This situation is contrasted with Japan, where, despite no financial or technological restrictions, brain death is not recognized, and transplants from brain-dead bodies cannot be performed. The Japanese cultural debate over the past twenty-five years about the "brain-death problem" is presented, followed by an analysis of Japanese attitudes towards technological intervention into what is taken to be the "natural" domain, together with a discussion of current Japanese attitudes towards death. This debate is interpreted as one aspect of a search for moral order in contemporary Japan, revealing ambivalence about self and other, Japan and the West, and tradition and modernity.

Advisory Committees↗
PubMed2006

Reproduction as spiritual kin work: orthodoxy, IVF, and the moral economy of motherhood in Greece.

Bringing gender and kinship studies together with an anthropology of religion, in this article I demonstrate how urban Greek couples and clinical practitioners in the middle 1990s proceeded with in vitro fertilization (IVF) in the absence of government regulations, and did so with reference to cultural beliefs and social relations consistent with Greek Orthodox religious practice. Drawing on ethnographic observations at an Athens IVF clinic as well as on interviews with former patients, I argue that Athenian women, in particular, engage IVF as a kind of spiritual kin work, normalizing the use of medical techniques with reference to ideologies of motherhood that treat it as a woman's moral achievement and as a source of womanly suffering. Since the period of ethnographic research described here, and despite disapproval of the Greek Orthodox Church, legislation regulating the use of IVF and other methods of medically assisted reproduction has become law. This article reconciles how the Church can officially reject medically assisted means of reproduction that Athenian users have normalized with reference to spiritual beliefs and practices.

Attitude to Health↗
PubMed2005

A new rejection of moral expertise.

There seem to be two clearly-defined camps in the debate over the problem of moral expertise. On the one hand are the "Professionals", who reject the possibility entirely, usually because of the intractable diversity of ethical beliefs. On the other hand are the "Ethicists", who criticise the Professionals for merely stipulating science as the most appropriate paradigm for discussions of expertise. While the subject matter and methodology of good ethical thinking is certainly different from that of good clinical thinking, they argue, this is no reason for rejecting the possibility of a distinctive kind of expertise in ethics, usually based on the idea of good justification. I want to argue that both are incorrect, partly because of the reasons given by one group against the other, but more importantly because both neglect what is most distinctive about ethics: that it is personal in a very specific way, without collapsing into relativism.

Attitude of Health Personnel↗