This study reports the results of a study of Swedish psychiatrists’ responses to moral statements related to decision making in the psychiatric context. Use was made of the Moral Sensitivity Questionnaire, a modified instrument previously constructed from a theory of moral sensitivity. This Likert-type scale contains 30 items constructed from the following categories: interpersonal orientation, structuring moral meaning, benevolence, modifying autonomy, experiencing moral conflict, and trust in medical knowledge and principles of care. The purpose was to identify possible differences in (...) responses rather than to evaluate right or wrong responses. The analysis is based on 754 completed questionnaires. The results of the study showed some significant differences in the item and category levels; for example, male psychiatrists experienced more conflicts than female psychiatrists and agreed to a greater extent that medical knowledge was most important in deciding what was best for the patient. The results also showed that more female than male psychiatrists thought that the relationship with the patient was most important in psychiatric practice. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

Research on moral judgment has been dominated by rationalist models, in which moral judgment is thought to be caused by moral reasoning. The author gives 4 reasons for considering the hypothesis that moral reasoning does not cause moral judgment; rather, moral reasoning is usually a post hoc construction, generated after a judgment has been reached. The social intuitionist model is presented as an alternative to rationalist models. The model is a social model in that it deemphasizes the private reasoning done (...) by individuals and emphasizes instead the importance of social and cultural influences. The model is an intuitionist model in that it states that moral judgment is generally the result of quick, automatic evaluations (intuitions). The model is more consistent than rationalist models with recent findings in social, cultural, evolutionary, and biological psychology, as well as in anthropology and primatology. (shrink)

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

Purpose/methods: This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. Findings: The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master's degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, (...) versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Conclusion: Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers. (shrink)

Ethical sensitivity was introduced to caring science to describe the first component of decision making in professional practice; that is, recognizing and interpreting the ethical dimension of a care situation. It has since been conceptualized in various ways by scholars of professional disciplines. While all have agreed that ethical sensitivity is vital to practice, there has been no consensus regarding its definition, its characteristics, the conditions needed for it to occur, or the outcomes to professionals and society. The purpose of (...) this article is to explore the meaning of the concept of ethical sensitivity based on a review of the professional literature of selected disciplines. Qualitative content analysis of the many descriptors found within the literature was conducted to enhance understanding of the concept and identify its essential characteristics. Ethical sensitivity is considered to be an emerging concept with potential utility in research and practice. (shrink)

Emotion experience reflects some of the outcomes of the mostly nonconscious processes that compose emotions. In my view, the major processes are appraisal, affect, action readiness, and autonomic arousal. The phenomenology of emotion experience varies according to mode of consciousness (nonreflective or reflective consciousness), and to direction and mode of attention. As a result, emotion experience may be either ineffable or articulate with respect to any or all of the underlying processes. In addition, emotion experience reflects the degree to which (...) the emotion processes control perception, thought, action and bodily arousal. (shrink)

We report the results of an investigation of nurses’ and physicians’ sensitivity to ethical dimensions of clinical practice. The sample consisted of 113 physicians working in general medical settings, 665 psychiatrists, 150 nurses working in general medical settings, and 145 nurses working in psychiatry. The instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting Likert-type questionnaire consisting of 30 assumptions related to moral sensitivity in health care practice. Each of these assumptions was categorized into a theoretical dimension of moral (...) sensitivity: relational orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict, and following the rules. Significant differences in responses were found between health care professionals from general medical settings and those working in psychiatry. The former agreed to a greater extent with the assumptions in the categories ‘meaning’ and ‘autonomy’ and to a lesser degree with the categories ‘benevolence’ and ‘conflict’. Moreover, those from the psychiatric sector agreed to a greater extent to the use of coercion if necessary. Significant differences were also found for some of the MSQ categories, between physicians and nurses, and between males and females. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:?;5. HUME AND SPINOZA It is strange that there has been so little interest in comparing two great philosophers, Hume and -Spinoza, who were both so important and influential in bringing about the decline of traditional religion. Jessop's bibliography indicates no interest in Hume and Spinoza up to the 1930 's. The Hume conferences of 1976, as far as I have been able to 2 determine, avoided the topic. (...) In one of the better new Hume volumes, Livingston and King, Hume, A Re-evaluation, 3 Spinoza is cited twice, and once incorrectly at that. On the other hand, in the massive new Spinoza volume edited by Siegfried Hessing, Speculum Spinozanun 1677-1977, Hume is mentioned four times, but only one of these has any real relevance to Hume's views vis-a-vis Spinoza's. Some discussion of Hume's comments, usually brief, occurs in the commentators. B. M. Laing, in David Hume, (London 1932), has just three short references to Spinoza. John Laird, in Hume's Philosophy of Human Nature, (London 1932) has a couple of cursory references to Spinoza, plus a bit more extended statement of Pierre Bay le" s critique of him. In H. H. Price, Hume's Theory of the External World, (Oxford 1940), there is one paragraph on Hume and Spinoza. In Norman Kemp Smith, The Philosophy of David Hume (London 1941), there are three references to Spinoza. Rachel Kydd, Reason and Conduct in Hume's Treatise (Oxford 194 6), has the greatest number of references to Spinoza. She was concerned to compare him with Hume on other matters than are dealt with in this paper, namely Spinoza's theory of reason and 9 the passions. In contrast, André Leroy, David Hume, (Paris 1953), has just one paragraph on Spinoza dealing with the immateriality of the soul; and Ernest C. Mossner, in his monumental Life of David Hume, (Austin 1954), has only one reference to Spinoza - James Beattie's denunciation of Hume, Hobbes, Malebranche, Leibniz and Spinoza. Lastly, in a fairly recent commentary by James Noxon, Spinoza is mentioned 66. three times, but not for anything in Hume's text. Noxon does point out (p. 75) that Spinoza is not mentioned in ] 2 Hume's correspondence. John H. Randall has offered an explanation for this neglect of Spinoza by Hume scholars, namely that "Hume stands for all time as the antithesis of Spinoza in his thought". In the England of Hume's day, Spinoza was little known, but still better known at the time than he was in France or England. Spinoza's Tractatus Theologico-Politicus 14 had been twice translated into English anonymously. He had been attacked by Bishop Stillingfleet, by John Evelyn, by Berkeley and several others. But Spinoza was not a major figure, except to the English Deists, and to Hume's early patron, the Chevalier Andrew Michael Ramsay. Most of the information known about Spinoza came from Pierre Bayle' s Historical and Critical Dictionary, where the article "Spinoza" is the longest in the Dictionary, about three hundred pages in length. My suspicion, or hypothesis, is that Hume first became interested in Spinoza through Ramsay, and then learned what he knew about Spinoza from Bayle' s article. When the young David Hume went to France to write his A Treatise of Human Nature in 1734, he went first to see the Chevalier Ramsay, who entertained Hume for about two weeks. Ramsay was a leading Scottish Catholic, was the teacher of Bonnie Prince Charlie, a leading Scottish revolutionary, 18 as well as the Grand Master of the Free Masons. With Ramsay's eclectic views it is not odd that he had a serious interest in Spinoza's theory, and that he was composing answers to it. Ramsay advised Hume about his own book, and Hume felt he had to show Ramsay the Treatise before he 19 brought it back to England. In the Treatise there is a not too well studied section on Spinoza, Of the immateriality of the soul 20 (T240-45). In introducing Spinoza into the discussion of 67. the immateriality of the soul, Hume follows what was common practice in his day, namely to insult Spinoza and his theory... (shrink)

The aim of the present study was to investigate the association between work-related moral stress, moral climate and moral sensitivity in mental health nursing. By means of the three scales Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire and Work-Related Moral Stress, 49 participants’ experiences were assessed. The results of linear regression analysis indicated that moral stress was determined to a degree by the work place’s moral climate as well as by two aspects of the mental health staff’s moral sensitivity. The (...) nurses’ experience of ‘moral burden’ or ‘moral support’ increased or decreased their experience of moral stress. Their work-related moral stress was determined by the job-associated moral climate and two aspects of moral sensitivity. Our findings showed an association between three concepts: moral sensitivity, moral climate and moral stress. Despite being a small study, the findings seem relevant for future research leading to theory development and conceptual clarity. We suggest that more attention be given to methodological issues and developing designs that allow for comparative research in other disciplines, as well as in-depth knowledge of moral agency. Copyright © 2011 by SAGE Publications. (shrink)

In the debate concerning the education of nurses that is currently taking place in Denmark, two widely differing views are apparent regarding the best way of training nurses such that the ethical aspect of their work is adequately considered. The first of these is based on the premise that practical care is fundamental to and justified by theories on nursing, care and ethics, which is why the theoretical part of nurse education deserves a higher priority. The second view is based (...) on the premise that social care cannot be taught by means of theories, but can be learnt only through practice. The master-apprentice principle of ancient Greece is stressed in connection with this as being a viable alternative to the theoretical model of education. These two very different views can be traced back to Plato’s and Aristotle’s ideas on ethics and teaching respectively; indeed, those engaged in the debate make specific reference to these philosophers. In Denmark, a third fundamental viewpoint exists, known as ‘ontological ethics’. Phenomenologist KE Løgstrup is one of the best-known representatives of this view. Basing the line of argument on Løgstrup’s ethics and the view of education associated with this, this article questions the relevance of ancient Greek thought to today’s world by illustrating a number of problems that are connected with the theoretical model of nurse education and with the master-apprentice principle. Løgstrup associates ethics with the aesthetic principle that ‘the useless is the most useful’ in human life and with the view we also see in Kierkegaard’s and NFS Grundtvig’s writings that ethics can be imparted only by indirect means. Løgstrup bases his understanding of ethics on the Judaeo-Christian concept of Genesis and the view that human beings were created with an ethical potential that is best nourished by aesthetic impressions. (shrink)

Fourteen experienced psychiatric nurses participated in a pilot study aimed at describing the experiential aspect of making decisions for the patient. In-depth interviews focused on conflicts, were transcribed, coded, and categorized according to the Grounded Theory method. The theoretical construct, 'modifying autonomy' and its dimensions, such as being aware of the patient's vulnerability, caring for and caring about the patient, were identified. The findings in this study make clear the need for further research into the experiential aspect of ethical decision-making (...) in psychiatric practice. (shrink)