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PubMed1992

[Ethics, health & society].

The sudden advent of new technological devices and sophisticated methods in both biological research and medical practice alerted different social groups to the development of unprecedented problems for moral counsel and decision-making. The field of study called bioethics grew out of religiously motivated concerns, but nowadays it attracts the attention of politicians, lawyers, religious thinkers, philosophers, scientists and doctors. Bioethics is becoming a sphere of interest to an increasing number of people. Each of these groups bring their own values, which are sometimes not in total agreement with the traditional values of medical ethics, to discussion. Therefore, the Author defends a more active participation of doctors through their representative bodies in the discussion of policies concerning the research and development of new technologies, and also the individual use of them when they are available, so that the practice of medicine may preserve the hippocratic legacy, accepting only the external influences when they are not in conflict with the intrinsic morality of medicine.

Bioethics↗
PubMedDate not supplied

Morale of mental health professionals in Community Mental Health Services of a Northern Italian Province.

AIMS: To explore morale of psychiatrists and psychiatric nurses working in Community Mental Health Centres (CMHC) in an Italian Province, and identify influential factors. METHODS: Thirty psychiatrists and 30 nurses working in CMHCs in Modena completed questionnaires on burnout, team identity and job satisfaction. They also answered open questions about different aspects of their work. Answers were subjected to content analysis. Regression analyses were used to identify factors that predicted morale across groups. RESULTS: Psychiatrists had higher scores on emotional exhaustion and depersonalisation. There were no significant differences between the two groups in job satisfaction and job or role perception. Professionals reported positive relationships with patients as the most enjoyable aspects of their job, whilst team conflicts and high workloads were seen as most difficult to cope with. Multivariate analyses showed that being a psychiatrist and perceiving team conflicts as a main cause of pressure in the job predicted higher burnout. CONCLUSIONS: Simple open questions coupled with quantitative measures appear a promising tool to investigate morale of mental health professionals and identify factors determining morale. Research, training and service development should focus on relationship aspects both with patients and within teams to reduce burnout in CMHCs.

Adult↗
PubMed1988

Interrelations of empathy, cognition, and moral reasoning with dimensions of juvenile delinquency.

The interrelations of a variety of indices of sociocognitive development (empathy, role-taking, logical cognition, and moral reasoning) were studied in delinquent and nondelinquent adolescents. Delinquent males (grouped into psychopathic, neurotic, and subcultural subgroups) and a matched nondelinquent comparison group were administered individually two empathy scales (the Davis Interpersonal Reactivity Index and the Mehrabian and Epstein Questionnaire Measure of Emotional Empathy), an adaptation of Byrne's and Flavell's role-taking tasks, two Piagetian cognitive tasks, and two of Kohlberg's structured moral dilemmas. Delinquents as a group displayed significantly more immature modes of role-taking, logical cognition, and moral reasoning than did nondelinquents. The delinquent subgroups, however, did not significantly differ from one another on these dimensions. Role-taking, logical cognition, and moral reasoning were significantly related to one another. Anticipated differences in level of empathy between the delinquent and nondelinquent adolescents failed to occur. A number of interpretations for this unexpected finding are offered.

Adolescent↗
PubMedDate not supplied

Why did she do that? Issues of moral conflict in battered women's decision making.

This qualitative research study was undertaken, in part, in an effort to develop an understanding of decisions experienced as moral conflicts by women who have experienced abuse by an intimate partner. Eighteen rural women who had been or were currently in an abusive relationship with a male partner participated in the study. An adaptation of the Real-Life Moral Conflict and Choice Interview (L. M. Brown, 1988) was used to gather and interpret the data. This method required each participant to describe a real life dilemma and her response to that dilemma. In this article the author discusses the types of decisions described by the women. The decisions are organized into 3 categories that emerged from the interview narratives: the decision to leave the abusive relationship, decisions that threaten sense of self, and decisions of resistance. The findings of this study make explicit some of the dimensions of moral conflict inherent in decisions battered women make. Explication of these moral conflict issues and the ways in which women seek to resolve them provide another avenue through which to understand a battered woman's life, a perspective not found in other studies.

Adult↗
PubMed2004

[Psychosexual development and sexual education].

The bio-environmental influence on the sexual development and ripeness includes to the morality as the essential element of the behavioral expression. There are few studies directed to the interface between the healthy sexual development and the early intervention destined for the child-youth sexual risky behaviors. A suitable development sociomoral waits that every individual genuine participant and healthily in his sexuality to share it with another human being, without moving away from his expression. Some behavioral differences between the genders are described; goals of development; importance of assigning sexual education to the child-youth population, its vectors and preventive recommendations in domestic and/or school ambiences, directed to the personnel of health, as the avoidance of not wished pregnancy, the prevention of STD and other behaviors of risk. It is invited to the revaluation of the welfare services; supervision of programs, familiar participation; increase of the education in means of information, with personal and social responsibility. Such a consolidation requires from the health personnel the fulfillment of the educational-preventive recommendations of the professional performance to the advantage of a responsible practice.

Adolescent↗
PubMed2001

Divisibility and the moral status of embryos.

The phenomenon of twinning in early fetal development has become a popular source for doubt regarding the ascription of moral status to early embryos. In this paper, the possible moral basis for such a line of reasoning is critically analysed with sceptical results. Three different versions of the argument from twinning are considered, all of which are found to rest on confusions between the actual division of embryos involved in twinning and the property of early embryos to be divisible, to be based on highly questionable ethical assumptions, or to imply inconsistent claims regarding the moral importance of potentiality and/or the moral status of embryos. This is taken to expose a number of related inconsistencies in the moral basis of pro-life positions. In particular, ascribing moral significance to the property of being (in)divisible is found to be incompatible with the claim that human individuals possess unique values which could underpin an absolute moral ban on murder.

Beginning of Human Life↗
PubMed1992

Long-term psychological consequences of childhood frontal lobe lesion in patient DT.

Patient DT was examined 26 years after she acquired focal frontal lobe damage at 7 years of age. This report focused on several aspects of psychological outcome, including the empirical study of social development into early adulthood. Standardized measures of empathy, psychosocial development, and personality were analyzed, along with a moral judgment interview and patterns of adult social behavior. Results indicated that DT has a very limited capacity for empathic understanding, inadequate identity development, difficulties in vocational adjustment, and a concrete level of moral reasoning. Her social behavior and profile of test scores suggest that social development and adaptation have been arrested at early adolescent levels. We conclude that early frontal lobe damage has profound effects on social development, and that the frontal lobes provide a crucial neural substrate for social maturation.

Adaptation, Psychological↗
PubMed2004

Teaching medical ethics: implementation and evaluation of a new course during residency training in bahrain.

AIM: This paper describes the development, implementation and evaluation of a new biomedical ethics course. The major educational goal was to enable the participants to critically analyse and resolve ethical dilemmas based on sound ethical and moral reasoning. BACKGROUND: The course was developed and implemented in the Family Practice Residency Program (FPRP) in the Kingdom of Bahrain. METHODOLOGY: Thirty-six family physician trainees participated in this course in May 2002 and January 2003. The curriculum was divided into five sessions, and each session had specific objectives, contents and teaching methods. The course was evaluated using pre- and post-tests, direct observation of participants and overall course assessment. RESULTS: Evaluations demonstrated that the participants scored higher in the post-test than in the pre-test. There was a significant statistical difference between the mean scores of both tests. After completing the course, participants produced more justifiable decisions than those generated at the beginning and felt more confident discussing and reasoning their decisions based on sound ethical and moral concepts. CONCLUSION: Our experience had demonstrated that the trainees benefited from a structured curriculum in biomedical ethics. We believe that the development and implementation of our course may serve as a case study for training and teaching postgraduates in the area of medical ethics.

Adult↗
PubMed2004

Paid organ procurement: pragmatic and ethical viewpoints.

None of the familiar arguments against paid organ procurement really works. Most arguments spring from revulsion that arises from the abuses of the practice rather than the act itself. This has not stopped official condemnation. However, the evidence we have at present is that such condemnation, aimed at correcting a perceived moral wrong rather than at abuses of a practice (the correction of which might actually bring some moral good), has utterly failed, and many more countries including the United States now harbor paid organ procurement. We can try to develop and articulate a truly compelling moral argument against paid organ procurement or we can try to minimize the harm that comes out of this practice. Since it is unlikely that all countries will agree on a standardized approach in such a muddled field, the best way may be to let every country decide on what is best for itself. Some may want to ban the practice using legislation. Others may want to try regulating the practice, knowing full well that they cannot stop it and that turning a blind eye to the practice, or simply condemning it, does no good whatsoever and actually increases the harm because everything is done underground, with middlemen and mafia-like organizations making a lot of money out of a lot of misery. Some countries may choose to find other, more innovative solutions. We call attention to an important resolution dealing with this subject at the December 2002 ethics and transplantation congress in Munich.

Humans↗
PubMed1991

Four pathways in the analysis of adult development and aging: comparing analyses of reasoning about personal-life dilemmas.

Four systems for analyzing thinking about 2 personal-life dilemmas, as discussed by 29 men and 35 women (ages 35-85), were compared. Kohlberg's (1976) moral judgment stages, Kegan's (1982) ego-development stages, Gilligan's (1982) moral orientation system, and Suedfeld and Tetlock's (1977) integrative complexity scoring were used. Subjects completed Kohlberg's (Colby & Kohlberg, 1987) standard moral judgment measure, a self-concept description, and several questionnaires. The Kohlberg, Kegan, and integrative complexity codings of the dilemmas were positively related to each other and to the standard Kohlberg moral stage scores. There were no age-group differences and few gender differences on the measures. However, education, role-taking skills, and greater sensitivity to age changes in the self positively predicted higher stage scores across maturity.

Adaptation, Psychological↗
PubMed1990

The ethics of ex utero research on spare 'non-viable' IVF human embryos.

In this paper, the focus is not on some particular developmental feature of the human embryo, but rather on the embryo's potential for development tout court. To this end, the moral relevance of the difference between human embryos that have the potential for continued human growth and development and human embryos that do not have this potential is explored and a distinction between viable and non-viable IVF human embryos is introduced. This is followed by a discussion of what is morally wrong with killing to show that none of the concerns associated with the act of killing apply to the destruction of non-viable IVF human embryos. On this basis, it is argued that scientifically and ethically sound research on spare non-viable IVF human embryos may proceed.

Abortion, Eugenic↗
PubMedDate not supplied

Managing morale and productivity in central service.

Financial constraints resulting in limitations of human resources present management challenges throughout the healthcare industry. Lack of job security can cause fear and unrest among employees to spread like brush fire throughout the institution. Employees at all ends of the organizational chart may feel a sense of helplessness and powerlessness over the situation. This doesn't have to be the situation in Central Service. Rather than putting out fires and crisis management, a master plan for increasing department morale and productivity can be developed--a plan which ultimately benefits the Central Service staff and management. If a positive productivity cycle can be initiated, personnel can see how their behavior affects productivity. Once employees understand how productivity indicators are tied into the budgetary staffing allotments, their commitment to improving productivity becomes a personal one--they can work together to assure job security. This also provides some measure of control over the prevailing economic forces.

Central Supply, Hospital↗
PubMedDate not supplied

[The ethical and moral aspects of genetics research].

With the development of molecular biology, it has become necessary to analyze the impact and incidence of genetic diagnosis in human health. Genetic engineering allows the handling of biological information related specifically to each individual in order to identify genetic abnormalities produced by diseases, as well as the predisposition to them. Through detailed knowledge regarding genetic configuration of individuals, it is possible to detect such human predispositions to diseases and the organic response to different infectious agents, drugs, and chemical products. However, the results of these tests may be handled inside and outside medical contexts and with different purposes; therefore, the potential social control which could result from the manipulation of biological information must be considered. Thus, it is important to define who should have access to such information, taking into consideration the ethical aspects as well as the limitations of genetical research.

Ethics, Medical↗
PubMed1991

Toward a methodology for moral decision making in medicine.

The failure of medical codes to provide adequate guidance for physicians' moral dilemmas points to the fact that some rules of analysis, informed by moral theory, are needed to assist in resolving perplexing ethical problems occurring with increasing frequency as medical technology advances. Initially, deontological and teleological theories appear more helpful, but criticisms can be lodged against both, and neither proves to be sufficient in itself. This paper suggests that to elude the limitations of previous approaches, a method of moral decision making must be developed incorporating both coherence methodology and some independently supported theoretical foundations. Wide Reflective Equilibrium is offered, and its process described along with a theory of the person which is used to animate the process. Steps are outlined to be used in the process, leading to the application of the method to an actual case.

Bioethical Issues↗