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PubMed2001

Empathetic maturity: theory of moral point of view in clinical relations.

The article describes a cognitive structural theory of how nurses conceive or understand the personhood of patients. The theory postulates three levels that have the properties of cognitive structures. The third and highest level is held to be a meta-ethical theory of the moral structure of care. For nurses operating with level-III understanding, critiques of justice and care-based ethics are further held to be synthesized within.

Cognition↗

PubMedDate not supplied

Mutual moral caring actions: a framework for community nursing practice.

A community practice framework is presented as the synthesis of research findings from the analysis of a critical ethnonursing study of women in recovery from chemical dependence. Critical Social Theory is used to examine the paradoxical experiences of women from their lifeworld and system within the community. The framework focuses on the mutual moral caring actions of the community nurse and the women in the recovery. It is supported by the concepts of transcultural nursing ethics. The utility of the framework is to promote clarity of speech and parity of community membership for women in recovery from chemical dependence and their return to the community.

Attitude of Health Personnel↗

PubMedDate not supplied

"I got some swords and you're dead!": violent fantasy, antisocial behavior, friendship, and moral sensibility in young children.

Relations between an early interest in violent fantasy and children's social understanding, antisocial and emotional behavior, and interactions with friends were investigated in 40 "hard-to-manage" preschoolers and 40 control children matched for gender, age, and school and ethnic background. Children were filmed alone in a room with a friend, and tested on a battery of cognitive tests, including false-belief, executive function, and emotion understanding tasks. Teachers reported on their friendship quality. At age 6 years, the children's understanding of the emotional consequences of antisocial and prosocial actions was studied. The hard-to-manage group showed higher rates of violent fantasy; across both groups combined, violent fantasy was related to poor executive control and language ability, frequent antisocial behavior, displays of anger and refusal to help a friend, poor communication and coordination of play, more conflict with a friend, and less empathic moral sensibility 2 years later. The usefulness of a focus on the content of children's pretend play-in particular, violent fantasy-as a window on children's preoccupations is considered.

Age Factors↗

PubMedDate not supplied

The relation between law and morality: children's reasoning about socially beneficial and unjust laws.

This study investigated children's reasoning about laws and legal compliance. A total of 72 children, 24 each at 6, 8, and 10 years of age, made judgments of law evaluation ("Is it a good or bad law?"), legitimacy of legal regulation ("Is it OK or not for government to make a law?"), and law violation ("Is it OK or not for people to break the law?") for three socially beneficial laws (a traffic law, a vaccination law, and a law requiring compulsory education for children under 16) and three unjust laws (denial of education to a class of persons, denial of medical care to the poor, and age discrimination). Participants also evaluated the application of laws in conflict scenarios in which a socially beneficial law infringed on individual freedom. Results showed that children considered a number of factors in their judgments, including the perceived justice of the law, its socially beneficial purpose, and its potential for infringement on individual freedoms and rights. The findings showed that children apply moral concepts of harm, rights, and justice to evaluate laws and to inform their judgments of legal compliance.

Age Factors↗

PubMed1992

An experimental course of lectures on moral treatment for mentally ill people.

By the mid 19th century, a more humanitarian approach towards the care of the mentally ill had been implemented in reforming institutions in France and Britain. This was known as 'moral treatment' and amongst its chief exponents were Pinel (Paris), Tuke (York) and Browne (Dumfries). Dr Browne perceived that the asylum attendants required education about this modality of treatment, and to this end he initiated a 'one off' course of lectures for staff at the Crichton Royal Hospital. It is considered that this experiment in nursing education is of relevance to the evolution of the role of the psychiatric nurse.

Curriculum↗

PubMed1986

Staff's estimations of the performance of mentally handicapped adults on a test of moral knowledge.

This paper reports an investigation to determine whether staff in an Adult Training Centre could estimate the performance of adults who are mentally handicapped on a test of moral knowledge. It also sought to discover whether estimations are more accurate in instances where staff claim to have a closer knowledge of the subjects. Not only do the results indicate that training staff are unable to estimate accurately, but they overestimate knowledge in this subject area. The degree of knowledge of the subjects made no difference to the accuracy of staff estimations. The implications of these results are considered in terms of the training needs of staff in Adult Training Centre and the use of assessment criteria prior to the entry of students into specific training programmes.

Adult↗

PubMed1975

Moral and ethical problems of pre-natal diagnosis.

The moral and ethical problems resulting from application of pre-natal diagnosis are identified: abortion, questions about euthanasia for defective newborns, and the concept of genetic health. A holistic approach to ethical problems is presented that includes attention to both principles and consequences.

Abortion, Spontaneous↗

PubMedDate not supplied

Understanding perspectives and emotions in contract violation: development of deontic and moral reasoning.

Children between the ages of 3 and 10 years were presented with a set of pictures representing a contract with bilateral cheating options between a parent and child (Study 1) and between 2 peers (Study 2). The children had to (a) evaluate which situations violated the contract when the relevant information was presented, (b) anticipate the feelings of the violator and the victim, and (c) infer possible contract violation from 2 different perspectives when relevant information was covered. Results show that logical inferences about contract violation differ according to the type of task. Negative feelings attributed to the violator were dependent on age and type of relationship, revealing a content-sensitive codevelopment of cognitive abilities and moral reasoning in young children.

Child↗

PubMedDate not supplied

Returning to roots: on social information processing and moral development.

Social information processing theory has been posited as a description of how mental operations affect behavioral responding in social situations. Arsenio and Lemerise (this issue) proposed that consideration of concepts and methods from moral domain models could enhance this description. This paper agrees with their proposition, although it suggests that numerous additional concepts about the nature of latent mental structures (e.g., working models, schemas, scripts, object relations, classical conditioning) provide equally compelling refinements to processing theory. Furthermore, theoretical and methodological challenges in integrating latent mental structures into processing theory remain.

Affect↗

PubMedDate not supplied

Moral agency in nursing.

Moral agency involves risk. It is an action that is at odds with the traditional role of the nurse. However, as nurses assume more responsibility and accountability for client management and outcomes in an increasingly complex and uncertain environment, it is essential to approach ethical dilemmas in a manner consistent with the caring component of nursing. Case examples are utilized to illustrate the attributes necessary for nurses to fulfill their obligations in their nurse-client relationships.

Ethics, Nursing↗

PubMed2000

Commentary: value neutrality, moral integrity, and the physician.

The commentator agrees, in part, with Beckwith and Peppin that value neutrality is an illusion, both ethically and legally. He asserts, however, that a physician's moral autonomy does not sanction proselytizing to promote the physician's own values.

Abortion, Legal↗

PubMed2003

When therapists do not acknowledge their moral values: Green's response as a case study.

In this rejoinder to Green's (this issue) commentary on my article, I clarify several points of agreement and divergence with his critique. The failure of Green to be forthcoming about the sociopolitical and moral framework that infuses his response is unfortunately all too common in this literature. This places a limitation on the degree to which his comments can be contextually evaluated, though they remain didactically useful. Marriage and family therapists (MFTs) must realize that their underlying belief systems exact a profound influence on their conceptions about what constitutes mental health, valid treatment goals, and the best means to achieve these aims. These value frameworks may or may not be shared by religiously conservative and other clients who seek to develop their heterosexual potential. This has important, but often unrecognized, implications for clinical practice.

Attitude↗

PubMed1984

Moral reasoning and delinquent behaviour among students.

In a sample of students, relationships between delinquency and moral reasoning scores--on Rest's (1975) DIT--were consistent with the view that these scores reflect political orientation rather than developmental differences. More serious delinquency was positively correlated with principled reasoning for females (P less than 0.05), and negatively with Stage 4 reasoning for males (P less than 0.02).

Adult↗

PubMed1988

The moral philosophy of Maimonides.

Maimonides (1135-1204) wrote extensively on moral philosophical matters. In his three main works, the Commentary on the Mishnah, the Mishneh Torah, and the Guide of the Perplexed, he developed a far-reaching ethical system which is Aristotelian and yet is also greatly dependent upon the Rabbinic tradition. In this paper it is argued that Maimonides presents an effective synthesis of these apparently disparate traditions.

Health↗

PubMed1989

Surgical abortion at twenty weeks: is morality determined solely by the outcome?

A strong body of opinion contends that late terminations of pregnancy are better carried out by surgical methods. We show that the suggested advantages of greater safety and patient acceptance are based on out-of-date or inaccurate (biased) data. The advantages of medical methods are, however, equally unproven. However, we argue that the adverse emotional and symbolic effects of late surgical termination have moral force. We therefore contend that in the absence of strong patient preference, medical termination is the preferable method; and will remain of that opinion unless clear demonstration of the greater safety of surgical methods can be made at some future date.

Abortion, Induced↗

PubMed1992

Epidemiology and moral philosophy.

To an increasing extent ethical controversies affect and sometimes obstruct public health work and epidemiological research. In order to improve communication between the concerned parties a model for identification and analysis of ethical conflicts in individual-based research has been worked out in co-operation between epidemiologists and moral philosophers. The model has two dimensions. One dimension specifies relevant ethical principles (as beneficence, non-maleficence, autonomy and justice). The other dimension specifies the groups of persons involved in the conflict under consideration (for example: the study-population, individuals who may benefit from the results, the researchers and their personnel, the community at large). The model has been applied to the problem of legitimacy of case-register research and to problems in psychiatric health services research as well as epidemiological research.

Autopsy↗

PubMed2004

Helping medical students to find their moral compasses: ethics teaching for second and third year undergraduates.

The paper describes a two week course that has been offered as a special study module to intermediate level (second and third year) undergraduate medical students at Dundee University Medical School for the past five years. The course requires students to research the various aspects of ethical dilemmas that they have identified themselves, and to "teach" these issues to their colleagues in a short PowerPoint presentation as well as to prepare an extended 3000 word essay discussion. The course specifically asks students not to disclose their own ethical positions, as these are probably still in formation and the objective is to promote critical thinking capacity in ethical and moral issues as a prelude to the development of practical skills in dealing with clinical problems. The course is easy to resource for the school and has received universally high evaluations from the students since its inception.

Abortion, Induced↗

PubMed2005

The tension between self governance and absolute inner worth in Kant's moral philosophy.

The concepts of autonomy as the self governance of individuals and dignity as the inner worth of human beings play an important role in contemporary bioethics. Since both notions are crucial to Immanuel Kant's moral theory, it would be tempting to think that Kantian ethics could ease the friction between the two concepts. It is argued in this paper, however, that this line of thought cannot be supported by Kant's original ideas. While he did make a conscious effort to bring autonomy and dignity together, his emphasis on the absolute inner worth of our collective humanity made it impossible for him to embrace fully the personal self determination of individuals, as it is usually understood in today's liberal thinking.

Ethical Theory↗