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Critical Care Medicine Oct 2023
Topics: Humans; Burnout, Professional; Burnout, Psychological; Morals
PubMed: 37707380
DOI: 10.1097/CCM.0000000000005979 -
Journal of Advanced Nursing Oct 2023Both vulnerability and integrity represent action-guiding concepts in nursing practice. However, they are primarily discussed regarding patients-not nurses-and... (Review)
Review
BACKGROUND
Both vulnerability and integrity represent action-guiding concepts in nursing practice. However, they are primarily discussed regarding patients-not nurses-and considered independently from rather than in relation to each other.
AIM
The aim of this paper is to characterize the moral dimension of nurses' vulnerability and integrity, specify the concepts' relationship in nurses' clinical practice and, ultimately, allow a more fine-grained understanding.
DESIGN
This discursive paper demonstrates how vulnerability and integrity relate to each other in nursing practice and carves out which types of vulnerability pose a threat to nurses' moral integrity. The concept of vulnerability developed by Mackenzie et al. (2014) is applied to the situation of nurses and expanded to include the concept of moral integrity according to Hardingham (2004). Four scenarios are used to demonstrate where and how nurses' vulnerabilities become particularly apparent in clinical practice. This leads to a cross-case discussion, in which the vulnerabilities identified are examined against the background of moral integrity and the relationship between the two concepts is determined in more detail.
RESULTS AND CONCLUSION
Vulnerability and integrity do not only form a conceptual pair but also represent complementary moral concepts. Their joint consideration has both a theoretical and practical added value. It is shown that only specific forms of vulnerability pose a threat to moral integrity and the vulnerability-integrity relationship is mediated via moral distress.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE
The manuscript provides guidance on how the concrete threat(s) to integrity can be buffered and moral resilience can be promoted. Different types of threats also weigh differently and require specific approaches to assess and handle them at the micro-, meso- and macro-level of the healthcare system.
Topics: Humans; Ethics, Nursing; Morals; Surveys and Questionnaires; Nurses
PubMed: 37232274
DOI: 10.1111/jan.15717 -
The American Journal of Bioethics : AJOB Apr 2024
Topics: Humans; Stress Disorders, Post-Traumatic; Morals
PubMed: 38346157
DOI: 10.1080/15265161.2024.2313947 -
Archives of Sexual Behavior Mar 2024Some people believe rape is just as serious as homicide, or more serious, contrary to law. We examined the prevalence of this belief and whether it reflects an...
Some people believe rape is just as serious as homicide, or more serious, contrary to law. We examined the prevalence of this belief and whether it reflects an individual's political ideology and moral foundations. Analyses were based on a national YouGov survey of 1,125 US adults gathered in 2021. We found that only 26% of respondents believed rape was less serious than homicide. Most (61%) believed rape and homicide were equally serious, while 13% believed rape was more serious. Social progressives (particularly progressive women) were more likely than social conservatives to view rape as more serious or just as serious as homicide. However, this tendency was partially offset by the tendency of social progressives to view harm as a key factor in judging the morality of a behavior. We suggest that social progressives view rape more seriously than social conservatives because of their concern for gender inequality, but this concern is partially offset by their concern with harm.
Topics: Adult; Humans; Female; Rape; Homicide; Morals; Politics
PubMed: 38267597
DOI: 10.1007/s10508-023-02799-w -
The Behavioral and Brain Sciences Oct 2023Fitouchi et al. illustrate the cognitive and evolutionary foundations of puritanical morality, while leave the emotional foundation unclear. We complement their theory...
Fitouchi et al. illustrate the cognitive and evolutionary foundations of puritanical morality, while leave the emotional foundation unclear. We complement their theory by proposing moral emotions (e.g., guilt and shame) as characteristic emotions underlying puritanical morality. Our proposition is based on the findings that these moral emotions emerge after violations of puritanical norms and promote self-control and cooperation.
Topics: Humans; Emotions; Guilt; Shame; Morals; Self-Control
PubMed: 37789549
DOI: 10.1017/S0140525X23000353 -
F1000Research 2019Healthcare providers experience moral injury when their internal ethics are violated. The routine and direct exposure to ethical violations makes clinicians vulnerable...
Healthcare providers experience moral injury when their internal ethics are violated. The routine and direct exposure to ethical violations makes clinicians vulnerable to harm. The fundamental ethics in health care typically fall into the four broad categories of patient autonomy, beneficence, nonmaleficence, and social justice. Patients have a moral right to determine their own goals of medical care, that is, they have autonomy. When this principle is violated, moral injury occurs. Beneficence is the desire to help people, so when the delivery of proper medical care is obstructed for any reason, moral injury is the result. Nonmaleficence, meaning do no harm, has been a primary principle of medical ethics throughout recorded history. Yet today, even the most advanced and safest medical treatments are associated with unavoidable, harmful side effects. When an inevitable side effect occurs, the patient is harmed, and the clinician is also at risk of moral injury. Social injustice results when patients experience suboptimal treatment due to their race, gender, religion, or other demographic variables. While minor ethical dilemmas and violations routinely occur in medical care and cannot be eliminated, clinicians can decrease the prevalence of a significant moral injury by advocating for the ethical treatment of patients, not only at the bedside but also by addressing the ethics of political influence, governmental mandates, and administrative burdens on the delivery of optimal medical care. Although clinicians can strengthen their resistance to moral injury by deepening their own spiritual foundation, that is not enough. Improvements in the ethics of the entire healthcare system are necessary to improve medical care and decrease moral injury.
Topics: Humans; Stress Disorders, Post-Traumatic; Bioethics; Morals; Government; Health Facilities
PubMed: 38435121
DOI: 10.12688/f1000research.19754.4 -
Journal of Medical Ethics Aug 2023Machine learning (ML) systems play an increasingly relevant role in medicine and healthcare. As their applications move ever closer to patient care and cure in clinical...
Machine learning (ML) systems play an increasingly relevant role in medicine and healthcare. As their applications move ever closer to patient care and cure in clinical settings, ethical concerns about the responsibility of their use come to the fore. I analyse an aspect of responsible ML use that bears not only an ethical but also a significant epistemic dimension. I focus on ML systems' role in mediating patient-physician relations. I thereby consider how ML systems may silence patients' voices and relativise the credibility of their opinions, which undermines their overall credibility status without valid moral and epistemic justification. More specifically, I argue that withholding credibility how ML systems operate can be particularly harmful to patients and, apart from adverse outcomes, qualifies as a form of testimonial injustice. I make my case for testimonial injustice in medical ML by considering ML systems currently used in the USA to predict patients' risk of misusing opioids (automated Prediction Drug Monitoring Programmes, PDMPs for short). I argue that the locus of testimonial injustice in ML-mediated medical encounters is found in the fact that these systems are treated as on which patients' credibility is assessed. I further show how ML-based PDMPs exacerbate and further propagate social inequalities at the expense of vulnerable social groups.
Topics: Humans; Physician-Patient Relations; Morals
PubMed: 36635066
DOI: 10.1136/jme-2022-108630 -
Cambridge Quarterly of Healthcare... Apr 2024The question that this paper tries to answer is Q: "Can good academic bioethics be done without commitment to moral theory?" It is argued that the answer to Q is an...
The question that this paper tries to answer is Q: "Can good academic bioethics be done without commitment to moral theory?" It is argued that the answer to Q is an unequivocal "Yes" for most of what we could call "critical bioethics," that is, the kind of bioethics work that primarily criticizes positions or arguments already in the literature or put forward by policymakers. The answer is also "Yes" for much of empirical bioethics. The second part of the paper then provides an analysis of Q in relation to "constructive bioethics," that is, bioethics work aimed at providing an argument for a particular position. In this part, it is argued that a number of the approaches or methods used that initially look like they involve no commitment to moral theory, nevertheless, involve such a commitment. This is shown to be the case for reflective equilibrium, mid-level theory, the use of theory fragments, and argument by analogy.
Topics: Humans; Bioethics; Ethical Theory; Dissent and Disputes; Morals
PubMed: 37501615
DOI: 10.1017/S0963180123000348 -
Current Opinion in Psychology Jun 2024Successful leaders often use humor to motivate, inspire, and lead. Yet, recent research suggests that the use of humor is risky for leaders. Our review suggests that... (Review)
Review
Successful leaders often use humor to motivate, inspire, and lead. Yet, recent research suggests that the use of humor is risky for leaders. Our review suggests that humor must be morally offensive to some people for it to be perceived as funny. This inherent tension between humor and morality implies that the use of humor can sometimes act as a signal of acceptable moral standards in organizations, where a leader's use of humor carries significant risks because of the norm-violating message it sends to subordinates, or it can even be dangerous in extreme cases. We conclude the paper by offering future research directions on the study of workplace humor.
Topics: Humans; Morals; Wit and Humor as Topic; Leadership; Organizations
PubMed: 38330867
DOI: 10.1016/j.copsyc.2024.101799 -
Psychonomic Bulletin & Review Aug 2023To manage conflicts between temptation and commitment, people use self-control. The process model of self-control outlines different strategies for managing the onset...
To manage conflicts between temptation and commitment, people use self-control. The process model of self-control outlines different strategies for managing the onset and experience of temptation. However, little is known about the decision-making factors underlying strategy selection. Across three experiments (N = 317), we tested whether the moral valence of a commitment predicts how people advise attentional self-control strategies. In Experiments 1 and 2, people rated attentional focus strategies as significantly more effective for people tempted to break moral relative to immoral commitments, even when controlling for perceived temptation and trait self-control. Experiment 3 showed that as people perceived commitments to have more positive moral valence, they judged attentional focus strategies to be significantly more effective relative to attentional distraction strategies. Moreover, this effect was partly mediated by perceived differences in motivation. These results indicate that moralization informs decision-making processes related to self-control strategy selection.
Topics: Morals; Self-Control; Humans; Motivation; Decision Making; Male; Female; Adult; Attention
PubMed: 36849699
DOI: 10.3758/s13423-023-02257-7