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Acta Medica Portuguesa Sep 2022Moral distress occurs when one knows the morally correct action to take but is constrained from taking that action. The aims of this study were to translate into... (Review)
Review
INTRODUCTION
Moral distress occurs when one knows the morally correct action to take but is constrained from taking that action. The aims of this study were to translate into European Portuguese and culturally adapt the "Measure of Moral Distress - Healthcare Professionals" questionnaire to the context of the Portuguese healthcare system and to explore the frequency and intensity of moral distress occurring among medical students.
MATERIAL AND METHODS
The "Measure of Moral Distress - Healthcare Professionals" questionnaire was translated and culturally adapted to European Portuguese, following the internationally accepted "COnsensus-based Standards for the selection of health Measurement INstruments". Afterwards, a web-based survey was conducted, following the "Checklist for Reporting Results of Internet E-Surveys" guidelines. Medical students were asked to rate potentially morally distressing situations on frequency and intensity.
RESULTS
Of approximately 4300 medical students, 939 (22%) completed the survey. Participants experienced, on average, 16 morally distressing situations. Median of composite score of moral stress was 79 (IQR 44 - 118). Only 31% of the students felt well prepared to handle a morally distressing situation, 26% considered leaving medical school and 28% thought about choosing a non-clinical specialty due to moral distress.
CONCLUSION
Despite a plethora of studies on this topic, the results suggested that moral distress is still a common phenomenon among medical students with a cumulative effect over time. These results emphasize the importance of a critical review of medical education, reducing the harmful effects of preventable psychological phenomena in clinical practice and in the lives of future healthcare professionals.
Topics: Humans; Cross-Sectional Studies; Portugal; Stress, Psychological; Morals; Surveys and Questionnaires; Delivery of Health Care; Attitude of Health Personnel; Multicenter Studies as Topic
PubMed: 35080490
DOI: 10.20344/amp.16531 -
International Journal of Environmental... Aug 2021Some organisations, and some individual humans, violate moral and ethical rules, whether or not they are written down in laws or codes of conduct. Corporate...
Some organisations, and some individual humans, violate moral and ethical rules, whether or not they are written down in laws or codes of conduct. Corporate transgressions, as this behaviour is called, occur because of the actions of those in charge, usually bright and dedicated people. Immoral and unethical conduct can adversely affect the safety of workers, the general public and the environment. A scoping review method for a literature search is used to explore morality and ethics in relation to health and safety management. Our findings show that controlling the risks associated with misconduct and corporate transgression is not usually seen as a responsibility allocated to safety systems but is left to general management and corporate governance. The moral and ethical principles, however, can be applied in safety management systems to prevent misconduct and transgression-related safety risks. Our results show that ethical leadership, ethical behaviour, sustaining an ethical climate and implementation of an ethical decision-making process emerge as key preventive measures. The discussion presents a proposed way to include these measures in safety management systems. Conclusion and recommendations underline that unwanted behaviour and transgression risks can be brought under control, starting from a set of best practices. Not only the managers themselves but also board members, independent external supervisors and government regulators need to embrace these practices.
Topics: Humans; Leadership; Moral Obligations; Morals; Safety Management
PubMed: 34444260
DOI: 10.3390/ijerph18168511 -
Nurse Education Today Dec 2020The nurse accompanies individuals throughout their lives and, when in the hospital environment, provides care to those who face illness or injury. Nurses witness...
BACKGROUND
The nurse accompanies individuals throughout their lives and, when in the hospital environment, provides care to those who face illness or injury. Nurses witness numerous situations involving ethical dilemmas that require a prompt and effective response based on ethical and moral principles.
OBJECTIVES
This study aimed to determine whether bioethics education in nursing influences the level of moral competence and opinion of nursing students about three ethical dilemmas.
METHODS
A longitudinal study was conducted through the application of the MCTxt (Moral Competence Test extended) questionnaire, composed of three ethical dilemmas (worker, doctor and judge), on two separate occasions (before and after students completed the Bioethics and Nursing Ethics curricular unit, which covered a total of 32 h).
PARTICIPANTS
122 s-year students from a Portuguese nursing school.
RESULTS
Nursing students showed a moral competence stagnation (1.2-point difference between the two assessments), although this did not reach statistical significance (p = 0.268). Regarding performance for each of the dilemmas, students showed an increase in performance for the worker's and judge's dilemmas and a sharp decrease in performance for the doctor's dilemma.
CONCLUSIONS
The support of students by morally competent teachers and monitors, the development of methods that provide the development of critical judgement and decision-making ability, and the increase of hours for the Bioethics course unit seem crucial factors to develop nursing students' moral competence.
Topics: Bioethics; Ethics, Nursing; Humans; Longitudinal Studies; Moral Development; Morals; Students, Nursing
PubMed: 33010668
DOI: 10.1016/j.nedt.2020.104601 -
Proceedings of the National Academy of... Aug 2023Humans reason and care about ethical issues, such as avoiding unnecessary harm. But what enables us to develop a moral capacity? This question dates back at least to...
Humans reason and care about ethical issues, such as avoiding unnecessary harm. But what enables us to develop a moral capacity? This question dates back at least to ancient Greece and typically results in the traditional opposition between sentimentalism (the view that morality is mainly driven by socioaffective processes) and rationalism [the view that morality is mainly driven by (socio)cognitive processes or reason]. Here, we used multiple methods (eye-tracking and observations of expressive behaviors) to assess the role of both cognitive and socioaffective processes in infants' developing morality. We capitalized on the distinction between moral (e.g., harmful) and conventional (e.g., harmless) transgressions to investigate whether 18-mo-old infants understand actions as distinctively moral as opposed to merely disobedient or unexpected. All infants watched the same social scene, but based on prior verbal interactions, an actor's tearing apart of a picture (an act not intrinsically harmful) with a tool constituted either a conventional (wrong tool), a moral (producing harm), or no violation (correct tool). Infants' anticipatory looks differentiated between conventional and no violation conditions, suggesting that they processed the verbal interactions and built corresponding expectations. Importantly, infants showed a larger increase in pupil size (physiological arousal), and more expressions indicating empathic concern, in response to a moral than to a conventional violation. Thus, infants differentiated between harmful and harmless transgressions based solely on prior verbal interactions. Together, these convergent findings suggest that human infants' moral development is fostered by both sociocognitive (inferring harm) and socioaffective processes (empathic concern for others' welfare).
Topics: Humans; Infant; Morals; Moral Development; Wakefulness; Dissent and Disputes; Empathy
PubMed: 37487104
DOI: 10.1073/pnas.2306344120 -
Journal of Personality and Social... Aug 2011The moral domain is broader than the empathy and justice concerns assessed by existing measures of moral competence, and it is not just a subset of the values assessed...
The moral domain is broader than the empathy and justice concerns assessed by existing measures of moral competence, and it is not just a subset of the values assessed by value inventories. To fill the need for reliable and theoretically grounded measurement of the full range of moral concerns, we developed the Moral Foundations Questionnaire on the basis of a theoretical model of 5 universally available (but variably developed) sets of moral intuitions: Harm/Care, Fairness/Reciprocity, Ingroup/Loyalty, Authority/Respect, and Purity/Sanctity. We present evidence for the internal and external validity of the scale and the model, and in doing so we present new findings about morality: (a) Comparative model fitting of confirmatory factor analyses provides empirical justification for a 5-factor structure of moral concerns; (b) convergent/discriminant validity evidence suggests that moral concerns predict personality features and social group attitudes not previously considered morally relevant; and (c) we establish pragmatic validity of the measure in providing new knowledge and research opportunities concerning demographic and cultural differences in moral intuitions. These analyses provide evidence for the usefulness of Moral Foundations Theory in simultaneously increasing the scope and sharpening the resolution of psychological views of morality.
Topics: Adult; Attitude; Female; Humans; Intuition; Judgment; Male; Morals; Pilot Projects; Reproducibility of Results; Social Values; Surveys and Questionnaires
PubMed: 21244182
DOI: 10.1037/a0021847 -
PloS One 2022Recent years have not only seen growing public distrust in science, but also in the people conducting science. Yet, attitudes toward scientists remain largely...
Recent years have not only seen growing public distrust in science, but also in the people conducting science. Yet, attitudes toward scientists remain largely unexplored, and the limited body of literature that exists points to an interesting ambivalence. While survey data suggest scientists to be positively evaluated (e.g., respected and trusted), research has found scientists to be perceived as capable of immoral behavior. We report two experiments aimed at identifying what contributes to this ambivalence through systematic investigations of stereotypical perceptions of scientists. In these studies, we particularly focus on two potential sources of inconsistencies in previous work: divergent operationalizations of morality (measurement effects), and different specifications of the broad group of scientists (framing effects). Results show that scientists are generally perceived as more likely to violate binding as opposed to individualizing moral foundations, and that they deviate from control groups more strongly on the latter. The extent to which different morality measures reflect the differentiation between binding and individualizing moral foundations at least partially accounts for previous contradictory findings. Moreover, the results indicate large variation in perceptions of different types of scientists: people hold more positive attitudes toward university-affiliated scientists as compared to industry-affiliated scientists, with perceptions of the 'typical scientist' more closely resembling the latter. Taken together, the findings have important academic ramifications for science skepticism, morality, and stereotyping research as well as valuable practical implications for successful science communication.
Topics: Attitude; Humans; Morals; Physicians; Stereotyping; Universities
PubMed: 36190951
DOI: 10.1371/journal.pone.0274379 -
BMC Medical Ethics Sep 2014The debate on the ethical aspects of moral bioenhancement focuses on the desirability of using biomedical as opposed to traditional means to achieve moral betterment.... (Review)
Review
BACKGROUND
The debate on the ethical aspects of moral bioenhancement focuses on the desirability of using biomedical as opposed to traditional means to achieve moral betterment. The aim of this paper is to systematically review the ethical reasons presented in the literature for and against moral bioenhancement.
DISCUSSION
A review was performed and resulted in the inclusion of 85 articles. We classified the arguments used in those articles in the following six clusters: (1) why we (don't) need moral bioenhancement, (2) it will (not) be possible to reach consensus on what moral bioenhancement should involve, (3) the feasibility of moral bioenhancement and the status of current scientific research, (4) means and processes of arriving at moral improvement matter ethically, (5) arguments related to the freedom, identity and autonomy of the individual, and (6) arguments related to social/group effects and dynamics. We discuss each argument separately, and assess the debate as a whole. First, there is little discussion on what distinguishes moral bioenhancement from treatment of pathological deficiencies in morality. Furthermore, remarkably little attention has been paid so far to the safety, risks and side-effects of moral enhancement, including the risk of identity changes. Finally, many authors overestimate the scientific as well as the practical feasibility of the interventions they discuss, rendering the debate too speculative.
SUMMARY
Based on our discussion of the arguments used in the debate on moral enhancement, and our assessment of this debate, we advocate a shift in focus. Instead of speculating about non-realistic hypothetical scenarios such as the genetic engineering of morality, or morally enhancing 'the whole of humanity', we call for a more focused debate on realistic options of biomedical treatment of moral pathologies and the concrete moral questions these treatments raise.
Topics: Biomedical Enhancement; Ethical Analysis; Ethical Theory; Humans; Moral Development; Motivation; Personal Autonomy; Social Behavior; Social Identification; Social Values
PubMed: 25227512
DOI: 10.1186/1472-6939-15-67 -
New Directions For Child and Adolescent... Nov 2022This study coordinates moral value development in adolescence, parenting style, and gender with issues of stability and specificity. The primary research question asked...
This study coordinates moral value development in adolescence, parenting style, and gender with issues of stability and specificity. The primary research question asked whether parenting styles of mothers and fathers influence the development of adolescent moral values, and secondary research questions asked whether adolescent moral values were stable and whether gender moderated predictive relations of parenting styles and adolescent moral values. At 14 and 18 years, a sample of 246 adolescents completed the Sociomoral Reflection Objective Measure - Short Form; at 14 years, mothers and fathers self-reported their parenting styles using the Parental Authority Questionnaire. Exploratory and confirmatory factor analyses established a 2-factor model of adolescent moral values across the two ages: Life and Social Contract captured prosocial aspects of morality that are left to individual choice, and Law and Social Order captured acts that are legally or morally obligatory for individuals to perform. Structural equation modeling investigated relations between parental parenting styles and the two adolescent moral value factors, with adolescent age, gender, and family SES as covariates. Both moral values factors had high stabilities across the 4-year period. Mothers' authoritarian parenting at 14 years, but not their authoritative or permissive parenting, negatively predicted Life and Social Contract moral values, but not Law and Social Order, in adolescents at 18 years, more so for boys. Fathers' parenting styles did not predict adolescents' moral values at 18 years. Girls and adolescents from higher-SES families had higher Life and Social Contract moral values at 14 years; boys experienced more increases in Life and Social Contract moral values from 14 to 18 years than girls. Stability and parental predictive validity of moral values for adolescence are discussed.
Topics: Male; Female; Adolescent; Humans; Parenting; Mothers; Parents; Morals; Fathers; Parent-Child Relations
PubMed: 36314351
DOI: 10.1002/cad.20488 -
Annual Review of Psychology Jan 2024There is always room for moral improvement. However, very few prior reviews have focused on the phenomenon of moral improvement of self, social relations, or society. We... (Review)
Review
There is always room for moral improvement. However, very few prior reviews have focused on the phenomenon of moral improvement of self, social relations, or society. We first consider prevailing notions of the self-concept by highlighting the niche of theory and research that identifies an improving self as a possible identity and basis of motivation to act better and to be better. Second, we discuss moral improvement in the context of social relations, especially the close interpersonal relations that should most facilitate moral improvement. Third, we examine the moral improvement of society, focusing on the factors that facilitate or inhibit caring about potential immorality despite the fact that issues such as inequality, discrimination, and the climate crisis seem to be morally distant and impersonal. Finally, we discuss future directions for theory, research, and application.
Topics: Humans; Morals; Interpersonal Relations; Motivation; Self Concept
PubMed: 37827197
DOI: 10.1146/annurev-psych-032420-031614 -
Current Opinion in Psychology Dec 2022We locate our review of recent social scientific literature on non-Western migrants in Western liberal democracies within two opposing master narratives: a subtractive... (Review)
Review
We locate our review of recent social scientific literature on non-Western migrants in Western liberal democracies within two opposing master narratives: a subtractive and an additive view of migration. Within this framework, we bring to light the contemporary conceptualizations of non-Western migrants in psychology by focusing on trauma. We then examine the cultural and moral clashes that sometimes arise from trans-global migration and the psychology of integration. We end by highlighting the importance of further research on cultural pluralism and omniculturalism to help foster more peaceful and diverse societies.
Topics: Humans; Transients and Migrants; Morals; Cultural Diversity
PubMed: 36099678
DOI: 10.1016/j.copsyc.2022.101454