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Gert's moral theory and its application to bioethics cases.

Bernard Gert's theory of morality has received much critical attention, but there has been relatively little commentary on its practical value for bioethics. An important test of an ethical theory is its ability to yield results that are helpful and plausible when applied to real cases. An examination of Gert's theory and his own attempts to apply it to bioethics cases reveals that there are serious difficulties with regard to its application. These problems are sufficiently severe to support the conclusion that Gert's theory is unacceptable as an approach for resolving bioethics cases, even relatively noncontroversial cases.

Bioethical Issues↗

[Gender representations and morality in the nursing profession].

This text is part of a dialogue between the authorserlating to two research projects: one on "The professional ambiguities, work conditions and the citizenship of nurses--a comparative study in the Federal District and São Paulo" and the other on "The impact of work conditions on the nurses in the Hospital São Paulo as to sexual and reproductive life". Nursing occupies a singular place in the health professions. Is is differentiated by numeric importance as well as by a professional practice which is almost exclusively feminine. Culturally, to care is attributed as a woman's task (nurse, mother teacher, social worker, etc.); to treat is a man's task (doctor, father, provider, etc.) The dichotomy between caring and treating denies other conflicts, relations of power, and of hierarchies established in the professional practice of nursing. These conflicts may be associated with: a) the founding myth of the origin of nursing, generator of a morality and a competence which condition htis professional practice; b) feminity, mothering, the administration of intimacy and body care, that is, the social representations of nursing with respect to gender; c) the androcentric character of power relations and those of sexuality which subsume the professional space of nursing.

Ethics, Nursing↗

[The bioethics of protection and the state's role: moral problems in unequal access to drinking water].

The aim of this study is to examine unequal access to drinking water as a public health problem in terms of normative and analytical tools in the bioethics of protection. Therefore, we analyze both the moral implications of unequal treatment of primary needs, such as situations of vulnerability and threat to population groups, and the public sector's responsibility in supplying safe water. In addition, solutions are proposed for the protection of public health and the promotion of legitimate personal development projects. The bioethics of protection reaffirms the state's role in maintaining the drinking water supply and recommends avoiding a policy of privatization of this public good, meanwhile justifying public policies to correct situations of social injustice.

Bioethical Issues↗

Cultural and moral values surrounding care and (in)dependence in late life: reflections from India in an era of global modernity.

In India, many are participating in a shift from the intergenerational family as the central site of aging and elder care, to an increasing reliance on individual selves, the state, and private institutions. Over recent years, the nation has witnessed a proliferation of old age homes and a new industry of aging-focused institutions offering social, emotional, and practical support for older persons living alone. This article examines Indians' perspectives on elder care and the significant changes underway in their nation and world. Qualitative ethnographic fieldwork was conducted primarily in Kolkata (formerly Calcutta) among older persons, their families, and community members, with a focus on old age homes. Beliefs and practices surrounding competing models of elder care--such as in the family or in old age homes--speak not only to elder care per se, but also to broader cultural-moral visions of the relationship among persons, families, and states, and the nature and aims of the human life course.

Activities of Daily Living↗

Weight loss competitions at the work site: impact on weight, morale and cost-effectiveness.

Three weight loss competitions were held in business/industrial settings. One competition was between three banks; the other two were within industries, either between employee teams selected at random or between divisions of the industry. Attrition in the competitions was less than 1 per cent and weight loss averaged 5.5 kg. Both employees and management reported positive changes in morale and employee/management relations, and both considered the competition important to the success of the program. The cost-effectiveness ratio ($ 2.93 per 1 per cent reduction in percentage overweight) is the best yet reported.

Body Weight↗

Risk as moral danger: the social and political functions of risk discourse in public health.

Risk is a concept with multiple meanings and is ideologically loaded. The author reviews the literature on risk perception and risk as a sociocultural construct, with particular reference to the domain of public health. Pertinent examples of the political and moral function of risk discourse in public health are given. The author concludes that risk discourse is often used to blame the victim, to displace the real reasons for ill-health upon the individual, and to express outrage at behavior deemed socially unacceptable, thereby exerting control over the body politic as well as the body corporeal. Risk discourse is redolent with the ideologies of mortality, danger, and divine retribution. Risk, as it is used in modern society, therefore cannot be considered a neutral term.

Australia↗

Locus of control, perceived constraint and morale among institutionalized aged.

Examination of the relationship between locus of control and life satisfaction was prompted by a report that external locus of control (belief in the controlling influence of others) promotes good morale for the institutionalized elderly. Contrary to this report, life satisfaction of fifty-six institutionalized elderly women was associated with internality (belief in personal influence). Life satisfaction was also inversely related to perception of institutional constraint (r = -.61), which was its most powerful determinant.

Aged↗

A factor analysis of life satisfaction, adjustment and morale measures with elderly adults.

Seven frequently used measures of life satisfaction, adjustment and morale were subjected to the techniques of construct validation. Data for the analysis was obtained from 259 people over the age of sixty who represented three clusters: nursing home residents, homebound older people and "community" aged. The data were analyzed through Alpha factor analysis methods. Items from six of the seven measures were found on the two factors that best represented the conceptual area of life satisfaction.

Aged↗

Moral reasoning in alcoholics and addicts: structure vs content.

19 alcoholics and 20 addicts were selected from the detoxified inpatient population of a VA hospital. 17 socioeconomically matched controls were drawn from the nonprofessional staff. Kohlberg's Moral Maturity scores were not significantly different for the three groups. However, the content variables involved in choosing between the value of life and law differentiated these groups. The value of reporting both structure and content was examined.

Adult↗

Treating drunk drivers with moral reconation therapy: a one-year recidivism report.

115 convicted drunk drivers were treated with Moral Reconation Therapy during their incarceration. Postrelease recidivism (rearrest) and convictions of these treated subjects was compared to a control group of 65 convicted drunk drivers who did not receive treatment due to limited bed space. Analysis showed a rearrest rate of 20% for the treated group during the first year of the program's operation compared to 27.6% for the control group during the same period. Subjects who participated in a structured aftercare program after release showed only a 4.3% recidivism rate.

Accidents, Traffic↗

The naturalistic fallacy: moral inferences drawn from research with children versus adults.

The naturalistic fallacy occurs when a person reads a report of scientific research and concludes that the moral implication of the research was included in the article when, in fact, it was not. For example, the fallacy is committed when a study contains the conclusion that TV advertising increases preference for sugar-based foods, but the reader later believes that the study concluded that TV advertising should be controlled. Previous research indicates that the commission of the fallacy was strong when memory for social research was tested. The present study showed that the commission of the fallacy was stronger when the research which was read involved children as subjects compared to adult subjects. Increased empathy for the subjects of a research article strengthens commission of the fallacy.

Age Factors↗

Treating drunk drivers with Moral Reconation Therapy: a two-year recidivism study.

115 DWI-convicted male inmates were treated with Moral Reconation Therapy during incarceration. Nearly two years after their release, subjects' postrelease arrest records were collected. Treatment group data were compared to a control group of 65 inmates who applied but did not enter treatment as bed space was limited. Analysis showed that 10.4% of the treatment group obtained additional DWI arrests after release compared to 15.6% of the control group. 14.3% of treated subjects received additional sentences compared to 21.5% of nontreated controls. Results were also analyzed for a group of 24 treated subjects who continued to participate in treatment after release. This aftercare group showed a postrelease DWI rate of only 4.2% and reincarceration rate of 8.3%.

Accidents, Traffic↗

Treating drunk drivers with Moral Reconation Therapy: a three-year report.

115 DWI-convicted male inmates were treated with the cognitive behavioral system of Moral Reconation Therapy during their incarceration. Three years after their release, subjects' postrelease arrest and reincarceration records were collected. In the treated group, 24 subjects participated in an extended aftercare program and were compared to a control group of 65 DWI-convicted inmates who did not enter treatment due to limited bed space. Analysis showed reincarceration rates of 36.9% for the 65 controls, 22.6% of the 115 treated subjects, and only 16.7% of the 24 aftercare clients.

Adult↗

Treating drug offenders with Moral Reconation Therapy: a three-year recidivism report.

70 male felony offenders treated with the cognitive behavioral approach of Moral Reconation Therapy during and after incarceration were assessed for rearrests and reincarceration 38 months after their release. They were compared to a nontreated control group of 82 male felony offenders. Recidivism in the treated group was 24.3% as compared to 36.6% for the control group. Analysis showed that steps completed significantly correlated with rearrests and recidivism and that the correlation between number of aftercare sessions and recidivism approached significance.

Adult↗

Current morale issues that impede the caregiving process of substance abuse/addictions nurses.

A telephone survey was conducted with 25 nurse managers of substance abuse/addictions programs in a metropolitan area to ascertain what morale issues impede the caregiving processes of their nursing staff. Five issues were repeatedly identified by all 25 nurse managers. Those issues were: (a) lack of credibility and respect for the nurse in the eyes of other members of the multidisciplinary team, (b) lack of understanding of the role of nurses in the substance abuse/addictions program on an inpatient unit; (c) lack of adequate preparation for the role, (d) lack of acceptance of the nursing role as defined by nursing, and (e) the care of patients with concurrent diagnoses. This article analyzes these issues from the perspective of reasons for existence and possible solutions.

Attitude of Health Personnel↗

The impact of drug testing on the morale and well-being of mandatory participants.

The impact of drug testing on the morale of mandatory participants was assessed through interviews and questionnaire responses of 500 intercollegiate athletes required to participate in a urine testing program. Subjects varied widely in their experiences. Most were not greatly affected, but some were embarrassed, humiliated, upset, and anxious about being inaccurately identified as drug users. Others experienced positive benefits: new information, a novel and interesting conversation piece, and a socially acceptable way to refuse drugs offered in friendship. Some said that testing benefited their athletic performance and school work. A number of recommendations were made to humanize and improve the experience: a better orientation about what to expect, more effective educational sessions, a warmer, more comfortable testing setting, more reasonable drug testing objectives, and more rigorous testing standards.

Adult↗