Coping with moral problems of adolescents in foster care.
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Adaptation, Psychological↗
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Self-evaluation in young children.
A series of studies was conducted to examine the development of self-evaluation in children aged 1-5 years. Developmental changes in children's reactions to achievement-related outcomes were assessed in a variety of contexts, using different tasks and different criteria for success. The first study of 1-3-year-olds revealed an increased social orientation after the age of 21 months. Only children over this age were more likely to look up at the experimenter after they had produced an outcome themselves than after the same outcome had been produced by the experimenter. These older children were also more likely than younger children to call their mothers' attention to their achievements in a free-play situation. In a second study, on a task with visibly salient success versus failure outcomes, children aged 2-5 years responded to success with positive affect (e.g., smiling) and to failure with avoidance reactions (e.g., looking away from the experimenter). Praise enhanced children's positive affective reactions to success, but its effect was modest. In the final study, winning or losing on a competitive task was not understood by children below age 33 months and had no effect on their affective reactions to the task. In contrast, winning enhanced older children's pleasure in completing the task. Three stages are proposed in the development of self-evaluation. In the first stage, children experience joy in causality, but they lack the cognitive representational skills required for self-evaluation in a self-reflective sense, and they do not anticipate others' reactions to their performance. In the second stage, beginning before the age of 2 years, children anticipate adult reactions, seeking positive reactions to their successes and endeavoring to avoid negative reactions to failure. The proposed third stage involves a gradual internalization of external reactions, with children beginning to evaluate their performance and react emotionally to success and failure independently of their expectations of adult reactions. Although all studies focused on achievement outcomes, the development of self-evaluation in the moral domain may parallel this developmental sequence proposed for the achievement domain. It is also proposed that caretakers' reactions to rule violations might engender concerns about meeting adult expectations in achievement contexts.
Achievement↗
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↗
The efficacy and effectiveness of process consultation in improving staff morale and absenteeism.
OBJECTIVES: The purpose of this randomized controlled trial was to test the efficacy and effectiveness of process consultation consisting of a series of nurse manager-consultant problem-solving meetings for leadership development that would lead to their staff's improved morale, quality of care, and reduced absenteeism. METHODS: Thirteen consenting clinical inpatient units were stratified for four variables known to affect outcome and were then randomly assigned to treatment and control conditions. The nurse managers from the seven experimental units were paired with outside nurse consultants from the McMaster University School of Nursing (Hamilton, Ontario, Canada) in a cooperative form of retraining in problem-solving through process consultation. Morale was determined through measures of perceptions of the work environment, an attitude scale concerning work (alienation), a personality measure (hardiness), and one of each scale for work satisfaction and for sources of satisfaction and dissatisfaction. Demographic data and information regarding family life responsibilities were collected as well. Assessment of quality of care was determined by the frequency and type of incident reports and by patients' perception of their satisfaction. A ratio of absence hours to total paid hours of work was used to compare experimental and control units' absenteeism rates. RESULTS: Experimental subjects reported a statistically significant improvement in the characteristics of their work setting and in the quality of working relationships. The consultation process facilitated a perceived change in the organizational context of the experimental hospital units with less centralization of authority and more clarity about expectation. These organizational changes were accompanied by improved working relationships and less alienation from work. There was no statistically significant difference in absenteeism. However, a subanalysis of the units by "dose" of the intervention identified those who benefited from the effects of the consultation. Subjects whose nurse managers participated more actively in the consultation process accounted for the changes in working relationships and perceived organizational changes. The "low-dose" experimental subjects were more like the control subjects, with the exception of absenteeism, for which they had higher rates. CONCLUSIONS: The findings of this study suggest that process consultation can alter the staff's perceptions of the characteristics of the work setting, can reverse negative attitudes (alienation), and can create a more positive and supportive working environment (improved working relationship). However, the results suggest the need to target this type of intervention to managers who have the personal resources to engage in self-evaluation and personal development and thus to participate in the consultative process.
Absenteeism↗
The limited role of splenectomy in patients with leukemia.
Splenectomy is a valuable method of management of approximately 80 per cent of patients with hairy cell leukemia who have hypersplenic complications develop; operation can be performed with minimal morality and morbidity. Removal of the spleen also provides useful palliation in patients with chronic lymphocytic leukemia who have symptomatic splenomegaly or autoimmune hemolytic anemia; success is less predictable when operation is performed for thrombocytopenia. Splenectomy is linked with a high mortality and is of little benefit in patients with chronic granulocytic leukemia except when operation is performed as a prerequisite to bone marrow transplantation. Several patients with acute leukemia who have signs of splenic infarction and intra-abdominal bleeding develop had a short survival period after splenectomy.
Adult↗
[Cloning and stem cells. Social, ethical and moral impact].
Stem cells are non-specialised cells, but capable to develop into differenciated (or specialised) cells, that maintain a specific function until they die. Stem cells are obtained from blastocysts. Despite of their therapeutic potential, their origin has generated much controversy and confrontation because of ethical (and moral.) reasons. However, stem cells can also be supplied by adult cells, that are present in the tissue in a quiescient stage, waiting for the appropriate signals to develop into differenciated cells. This type cells is an alternative source for stem cells, and their utilization for medical treatment of degenerative diseases presents no ethical problems.
Animals↗
Vulnerable populations and morally tainted experiments.
This article addresses the dilemma facing an editor when he or she has to decide whether or not to publish a manuscript that describes unethical research. I will explore three options the editor may follow: a) publish the unethical research; b) publish it with an explicit condemnation of the methods used; c) reject the article on moral grounds. I will consider the importance of deterring unethical research, why the deterrence argument has been overlooked and the relevance it has in developing countries which seem to be more exposed to morally tainted experiments. I will suggest a combined policy. For cases in which the ethical problems are serious -- where basic human rights are not respected, where consent has been given without complete or proper information or voluntary participation by subjects, or where deceit has been practised -- I would support the strong policy of rejecting the article on moral grounds. For dubious cases, where the risk assessment can be doubted or where there are suspicions of ethical problems, I argue for a policy under which the article is published along with a serious discussion of the ethical problems suspected, allowing a rebuttal by the authors. In this way, while maintaining a strong deterrent policy, we recognize that sometimes it is not so clear if a research project was unethical, and only in such cases (where the ethical problems are dubious), the article may be published with an editorial.
Biomedical Research↗
The dilemma of science and morals.
The conflicts between science and morals which still continue to arise despite the apparent hegemony of atheistic scientism over traditional Judeo-Christianity in the twentieth century reflect a basic contradiction in the metaphysical foundation of Western lives. As was set forth by Machiavelli, the contradiction inherent in Western ethics is that it is based on the simultaneous belief in both objectively valid moral truths and purely relative values of communal purpose. The achievements of twentieth century science have intensified these contradictions. Modern physics has put in question the validity of its own metaphysical basis, namely the belief in Natural Law, and modern biology has been unable to come to terms with the Cartesian dualism of body and soul. By contrast, Chinese lives are comparatively free of these contradictions, being founded on the philosophies of Confucianism and Taoism, to which the concepts of objectively valid truth or Natural Law are foreign. Recent developments in Western attitudes regarding science and morals can be interpreted as a movement away from the traditional belief in absolute truths towards a Chinese relativism.
China↗
When victims don't cry: children's understandings of victimization, compliance, and subversion.
How do children understand situations in which the targets of moral transgressions do not complain about the way they are treated? One-hundred and twenty participants aged 5, 7, 10, 13, and 16 years were interviewed about hypothetical situations in which one child ("transgressor") made an apparently unfair demand of another child ("victim"), who then responded by either resisting, complying, or subverting. In general, 5-year-olds judged compliance positively and resistance negatively and 7- to 16-year-olds judged resistance positively and compliance negatively; all but 16-year-olds judged subversion negatively. Most participants judged the transgressor's actions negatively, regardless of how the victim had responded. The findings are discussed in terms of their implications for children's developing understandings of victimization.
Adolescent↗
Two kinds of potentiality: a critique of McGinn on the ethics of abortion.
In Moral Literacy, or How to Do the Right Thing, Colin McGinn proposes a consequentialist solution to the abortion dilemma. McGinn interprets moral rights and moral interests as attributable only to actually sentient beings by virtue of their ability to experience pleasure or pain. McGinn argues against the moral rights of potentially conscious human fetuses, on the grounds that the unjoined ova and spermatoza of any fertile men and women are also potentially sentient, but we do not generally suppose that unjoined human genetic germ plasm has moral rights. I argue that McGinn's reply equivocates between two different senses of 'potential sentience.' I distinguish between strong and weak potentiality, or between naturally probably potentiality and merely logically possible potentiality. I agree that it is reasonable to deny that a weak or merely logically possible potentially sentient fetus that would result from any unjoined ovum and sperm has a moral right to life. But I claim that this fact does not diminish the plausibility of extending a moral right or potential moral right to life to a naturally probable potentially sentient fetus, which we have good reason to believe will actually become sentient in the natural course of things if nothing is done to prevent its normal development. I conclude that it is not merely the potentiality, but the strong potentiality of a healthy, normally developing fetus that is soon to acquire sentience, moral interests, and, on McGinn's own terms, a moral right to life, that continues to sustain the abortion controversy, even among those who also want respect a woman's right to reproductive self-determination.
Abortion, Induced↗
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↗
Ethics; 'in consideration of the love he bears.' Apprenticeship in the nineteenth century, and the development of professional ethics in dentistry. Part 1. The practical reality.
This paper takes a look at the ancient institution of apprenticeship. In doing so it regards the conventions of the scheme as having had a positive influence on the morality, legal identity, and professional allegiance of dentists during the ethical development of their profession in the nineteenth century. Two important effects can be detected from the records available. One is general, since the moral ground of apprenticeship derived from, and spread throughout, society, and the other is particular to the development of dentistry as a profession, as those who were apprenticed to dentists acquired a natural loyalty to their dentist Masters in person, and to their craft.
Clinical Clerkship↗
The superego: a revised developmental model.
The superego is not, as psychoanalytic theory asserts, primarily heir to the oedipus complex. Freud proposed two theories of identification and superego formation, only one of which is widely known and accepted. The first, which he abandoned, argues for the genesis of conscience as compensation for lost narcissism. The second explains superego formation as a response to object loss and fear of castration. The latter view faces a number of anomalies, including the occurrence of preoedipal and postoedipal identifications unrelated to the castration complex, and the difficulty in providing a cause for female superego development. An alternative theory is proposed that returns to Freud's first theory of identification, arguing that gender-specific explanations are inappropriate for a phenomenon such as conscience, which occurs in both sexes. Prototypical male and female cases are presented alongside a general model of the development of ego processes and object relations. Case material is briefly examined, and the argument is made for conceptualizing psychosexual development as a developmental line rather than as the core of character formation.
Adult↗
The moral status of a human fetus: a response to Lee.
It is an undeniable empirical fact that a human fetus is a member of the species homo sapiens from the moment of conception. There is thus an important sense in which it is a human being in itself, and not simply part of a pregnant woman's body, despite what defenders of abortion on demand might want us to think. It is also reasonable to suppose that all human beings, and thus human fetuses, are persons, with all that entails, but this is a metaphysical presupposition as opposed to an empirical fact, and is thus contentious. It is argued, however, that this should be of little comfort to the defenders of abortion, because the mere fact that human fetuses have an inherent tendency to become persons is sufficient reason to confer a moral status upon them, which renders abortion morally problematic at best.
Abortion, Induced↗
Against over-estimating the role of ethics in technology development.
The role of ethics in technology development has been often questioned, especially in the early days of societal reflection of technology. However, the situation has changed dramatically. Ethical consideration now is generally declared to be indispensable in shaping technology in a socially acceptable and sustainable way. The expectations of ethics are large; often even a kind of "New Ethics" is postulated. In the present paper an over-estimation of the role of ethics for technology development is rejected. It is argued that ethical reflection is, indeed, indispensable in certain problem areas and situation types; but there is, on the other hand, space for technology development free from the requirement for ethical reflection. The absence of a requirement for ethical reflection, however, always has to be considered relative to some "morale provisoire" (provisional morality) as an accepted normative framework within which technology development may occur without explicit ethical reflection. If this framework, however, is doubted or is shown to be insufficient the situation changes completely. Ethical reflection in this case becomes necessary, to consider this normative framework in order to offer modifications or supplements.
Engineering↗
Recognition of staff nurse job performance and achievements: staff and manager perceptions.
Recognition for job performance is central to staff nurse morale. However, little research has been done to identify recognition methods most valued by nurses themselves. The authors report results of a multisite survey conducted to compare staff and manager perceptions of meaningful recognition behaviors. They provide data for developing management interventions that may help to improve morale and increase retention. Given the financial constraints of the current environment, the nonmonetary recognition practices identified are of particular significance.
Achievement↗
Dances of death, occupational mortality statistics, and social critique.
In the late middle ages and early renaissance dances of death were a popular art form. Despite important differences in outlook, the moral messages of these art forms and of modern analyses of socioeconomic inequalities in mortality overlap considerably. This theme has survived in modern dances of death, which are popular in certain parts of Europe, especially in Germany and other German speaking countries in central Europe, and are clearly inspired by the late medieval and early renaissance examples. In the modern dances of death, however, unlike their historical counterparts, social critique (criticism of social inequality) is almost absent, although they include representations of differences between people in social position. Remarkably, references to socioeconomic inequalities in mortality, which have been documented extensively, are also uncommon in the modern examples. This raises important questions about public perception of social inequality in general and socioeconomic inequalities in mortality in particular, and it suggests that modern Western society has not developed the cultural means of conveying the moral message that follows from research into socioeconomic inequalities in health.
Culture↗
Generalized expectancy, situational perception, and morale among institutionalized aged.
This article was based on a larger study which sought to identify selected personality and situational variables that contribute to high morale of the institutionalized elderly. The relationship of generalized expectancy of control and perceived situational control to morale of the institutionalized aged was examined within a framework developed for the study. Locus of control, self-report, trust, self-rated health, and the Revised Philadelphia Geriatric Morale scales as well as a situational control of daily activities (SCDA) interview schedule were administered individually to 30 residents, aged 65 to 96, in four skilled nursing facilities. Congruence between internal orientation and self-determined SCDA resulted in higher morale than incongruence; however, congruence between external orientation and other-determined situations resulted in lower morale than incongruence.
Adaptation, Psychological↗