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Geriatric Nursing (New York, N.Y.) 2022Studies that objectively investigate patterns of everyday physical activity in relation to well-being and that use measures specific to older adults are scarce. This...
Studies that objectively investigate patterns of everyday physical activity in relation to well-being and that use measures specific to older adults are scarce. This study aimed to explore objectively measured everyday physical activity and sedentary behavior in relation to a morale measure specifically constructed for older adults. A total of 77 persons (42 women, 35 men) aged 80 years or older (84.3 ± 3.8) wore an accelerometer device for at least 5 days. Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS scores were significantly positively associated with number of steps, time spent stepping, and time spent stepping at >75 steps per minute. Sedentary behavior did not associate with PGCMS. Promoting PA in the form of walking at any intensity-or even spending time in an upright position-and in any quantity may be important for morale, or vice versa, or the influence may be bidirectional.
Topics: Male; Humans; Female; Aged; Sedentary Behavior; Exercise; Morale; Accelerometry
PubMed: 36099778
DOI: 10.1016/j.gerinurse.2022.08.007 -
The Journal of Medical Humanities Mar 2021We have never been so aware of masks. They were in short supply in the early days of COVID-19, resulting in significant risk to health care workers. Now they are highly...
We have never been so aware of masks. They were in short supply in the early days of COVID-19, resulting in significant risk to health care workers. Now they are highly politicized with battles about mask-wearing protocols breaking out in public. Although masks have obtained a new urgency and ubiquity in the context of COVID-19, people have thought about both the literal and metaphorical role of masks in medicine for generations. In this paper, we discuss three such metaphors-the masks of objectivity, of infallibility, and of benevolence-and their powerful role in medicine. These masks can be viewed as inflexible barriers to communication, contributing to the traditional authoritarian relationship between doctor and patient and concealing the authenticity and vulnerability of physicians. COVID masks, by contrast, offer a more nuanced and morally complex metaphor for thinking about protecting people from harm, authentic and trustworthy communication, and attention to potential inequities both in and beyond medical settings. We highlight the morally relevant challenges and opportunities that masks evoke and suggest that there is much to be gained from rethinking the mask metaphor in medicine.
Topics: COVID-19; Humans; Masks; Medicine; Metaphor; Morals; SARS-CoV-2
PubMed: 33683510
DOI: 10.1007/s10912-020-09676-w -
Rhode Island Medical Journal (2013) Apr 2022
Topics: Humans; Morals; Virtues
PubMed: 35349615
DOI: No ID Found -
Medicine, Health Care, and Philosophy Jun 2021A pertinent concern in the human enhancement debate is that human enhancement technologies (HET) are intrinsically bad and, hence, morally impermissible. This article...
A pertinent concern in the human enhancement debate is that human enhancement technologies (HET) are intrinsically bad and, hence, morally impermissible. This article evaluates the related claims about the intrinsic badness of HET by looking into philosophical theories of intrinsic value. It investigates how well-established conceptions of intrinsic value map onto typical bioconservative arguments about HET's intrinsic badness. Three predominant variants of these arguments are explored and found wanting: (i) HET are intrinsically bad owing to their unnaturalness; (ii) the pursuit of HET reveals intrinsically bad character ("the desire for mastery"); and (iii) HET will necessarily undermine intrinsically valuable things (e.g., human dignity). My analysis shows that the debate on intrinsic value places serious constraints on claims about the intrinsic badness of HET. More specifically, the analysis shows that bioconservative arguments are, for the most part, inconsistent, misconceived, and overly speculative. Enhancement interventions cannot be bearers of intrinsic value on any of its plausible understandings, and, even if we could grant such a possibility, there are no compelling reasons to presume that the intrinsic value of HET would be necessarily negative. As a result, claims regarding their moral impermissibility are unwarranted.
Topics: Biomedical Enhancement; Dissent and Disputes; Humans; Morals
PubMed: 33460008
DOI: 10.1007/s11019-021-10003-w -
Psychiatria Danubina 2021In this paper we see the personality of man through his comprehension as a moral entity. An entity that emerges, thinks morally and/or behaves morally, inseparable from...
In this paper we see the personality of man through his comprehension as a moral entity. An entity that emerges, thinks morally and/or behaves morally, inseparable from the society in which he lives as a moral being, and by its moral thinking and/or behaviour further defines the morals of the whole society. Accordingly, we present (post)modern society as a society of tolerance of value ambiguity. In that kind of society we perceive medical situation as moral situation and define the role of medical ethics in the field of biomedicine. In that kind of society politics is perceived as one of the social spheres where different varieties of systems of values of individuals or groups are publicly embraced, touched, or terribly unhappily pursued... all in the name of understanding man and his world. In order to prevent the victory of Thanatos, who prevails in the contemporary concept of politics and in postmodern global society, we suggest implementing applied bioethics as a form of metapolitics as an answer. We explain the idea of bioethics and suggest bioethical education as the operationalisation of metapolitics through bioethics as orientation knowledge, in both medicine and politics.
Topics: Bioethics; Ethics; Ethics, Medical; Humans; Morals; Politics; Psychiatry
PubMed: 35026832
DOI: No ID Found -
Journal of Religion and Health Apr 2022The aim of this research was to describe the evidence examining the approaches taken by mental health providers (MHPs) and chaplains to address symptoms related to moral... (Review)
Review
The aim of this research was to describe the evidence examining the approaches taken by mental health providers (MHPs) and chaplains to address symptoms related to moral injury (MI) or exposure to potentially morally injurious events (PMIEs). This research also considers the implications for a holistic approach to address symptoms related to MI that combines mental health and chaplaincy work. A scoping review of literature was conducted using Medline, PsycINFO, Embase, Central Register of Controlled Trials, Proquest, Philosphers Index, CINAHL, SocINDEX, Academic Search Complete, Web of Science and Scopus databases using search terms related to MI and chaplaincy approaches or psychological approaches to MI. The search identified 35 eligible studies: 26 quantitative studies and nine qualitative studies. Most quantitative studies (n = 33) were conducted in military samples. The studies examined interventions delivered by chaplains (n = 5), MHPs (n = 23) and combined approaches (n = 7). Most studies used symptoms of post-traumatic stress disorder (PTSD) and/or depression as primary outcomes. Various approaches to addressing MI have been reported in the literature, including MHP, chaplaincy and combined approaches, however, there is currently limited evidence to support the effectiveness of any approach. There is a need for high quality empirical studies assessing the effectiveness of interventions designed to address MI-related symptoms. Outcome measures should include the breadth of psychosocial and spiritual impacts of MI if we are to establish the benefits of MHP and chaplaincy approaches and the potential incremental value of combining both approaches into a holistic model of care.
Topics: Clergy; Humans; Mental Health; Military Personnel; Morals; Stress Disorders, Post-Traumatic
PubMed: 35290554
DOI: 10.1007/s10943-022-01534-4 -
Lancet (London, England) Feb 2022
Topics: Humans; Morals; Social Responsibility; Social Stigma; Vaccination
PubMed: 35151392
DOI: 10.1016/S0140-6736(22)00189-1 -
BMC Medical Ethics Aug 2023Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical... (Randomized Controlled Trial)
Randomized Controlled Trial
The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: a clinical randomized controlled trial.
BACKGROUND
Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses' moral reasoning, moral distress and moral sensitivity.
METHODS
In this randomized clinical trial study with a pre- and post-test design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals.
RESULTS
Adjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238-15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171-2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15-5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043-12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454-16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015-0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015-0.547, P = 0.009).
CONCLUSIONS
The results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students.
REGISTRATION
This randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016.
Topics: Humans; Iran; Morals; Moral Development; Surveys and Questionnaires; Ethics, Nursing; Nurses
PubMed: 37542315
DOI: 10.1186/s12910-023-00938-5 -
Theoretical Medicine and Bioethics Aug 2021This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called "experimental philosophical bioethics"...
This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called "experimental philosophical bioethics" (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people's moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments.
Topics: Bioethics; Ethical Theory; Humans; Judgment; Morals; Philosophy
PubMed: 34787789
DOI: 10.1007/s11017-021-09546-z -
BMC Medical Ethics Sep 2021Despite its ubiquity in academic research, the phrase 'ethical challenge(s)' appears to lack an agreed definition. A lack of a definition risks introducing confusion or... (Review)
Review
BACKGROUND
Despite its ubiquity in academic research, the phrase 'ethical challenge(s)' appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical. Using a rapid review methodology, we sought to review definitions of 'ethical challenge(s)' and closely related terms as used in current healthcare research literature.
METHODS
Rapid review to identify peer-reviewed reports examining 'ethical challenge(s)' in any context, extracting data on definitions of 'ethical challenge(s)' in use, and synonymous use of closely related terms in the general manuscript text. Data were analysed using content analysis. Four databases (MEDLINE, Philosopher's Index, EMBASE, CINAHL) were searched from April 2016 to April 2021.
RESULTS
393 records were screened, with 72 studies eligible and included: 53 empirical studies, 17 structured reviews and 2 review protocols. 12/72 (17%) contained an explicit definition of 'ethical challenge(s), two of which were shared, resulting in 11 unique definitions. Within these 11 definitions, four approaches were identified: definition through concepts; reference to moral conflict, moral uncertainty or difficult choices; definition by participants; and challenges linked to emotional or moral distress. Each definition contained one or more of these approaches, but none contained all four. 68/72 (94%) included studies used terms closely related to synonymously refer to 'ethical challenge(s)' within their manuscript text, with 32 different terms identified and between one and eight different terms mentioned per study.
CONCLUSIONS
Only 12/72 studies contained an explicit definition of 'ethical challenge(s)', with significant variety in scope and complexity. This variation risks confusion and biasing data analysis and results, reducing confidence in research findings. Further work on establishing acceptable definitional content is needed to inform future bioethics research.
Topics: Bioethics; Delivery of Health Care; Health Services Research; Humans; Morals
PubMed: 34587950
DOI: 10.1186/s12910-021-00700-9