Thomas Merton wrote extensively on spiritual and social issues, and his theories have profound implications on many areas of life. This book focuses on the significance of his reflections on work, which seek to transcend the complexities of professional life.

Scholars have shown renewed interest in the construct of courage. Recent studies have explored its theoretical underpinnings and measurement. Yet courage is generally discussed in its broad form to include physical, psychological, and moral features. To understand a more practical form of moral courage, research is needed to uncover how ethical challenges are effectively managed in organizational settings. We argue that professional moral courage (PMC) is a managerial competency. To describe it and derive items for scale development, we studied (...) managers in the U.S. military and examined prior work on moral courage. Two methods were used to measure PMC producing a five dimensional scale that organized under a single second-order factor, which we termed overall PMC. The five dimensions are moral agency, multiple values, endurance of threats, going beyond compliance, and moral goals. Convergent and discriminant validity are analyzed by use of confirmatory factor analysis procedures. We conclude by presenting a framework for proactive organizational ethics, which reflects how to support PMC as a management practice. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

The notion of role morality suggests individuals may adopt a different morality depending on the roles they undertake. Investigating role morality is important, since the mentality of role morality may allow agents to believe they can abdicate moral responsibility when acting in a role. This is particularly significant in the literature dealing with professional morality where professionals, because of their special status, may find themselves at odds with their best moral judgments. Here I tell (...) four stories and draw out some distinctions. I conclude that role morality is a genuine and useful distinction. However, I suggest that the purported distinction between role morality and professional morality is over‐determined. Therefore, alleged conflicts between the demands of role and profession (such as the different pressures on Pinto designers as employees and as engineers) are not conflicts between different kinds of demands, but rather conflicts arising from divergent roles that most workers will encounter regularly. Another analytical perspective is to look at moral choices at work in terms of power and the ability to bring about change. Finally, I draw the implication that we should stress moral awareness at a fairly abstract level for all employees and reinforce the moral primacy of individual choice. (shrink)

AbstractOrganizations receive multiple benefits when their members act ethically. Of interest in this study is if the actors receive benefits as well, especially as individuals look to work to fulfill psychological and social needs in addition to economic ones. Specifically, we highlight a series of ongoing ethical practices embodied in professional moral courage and their relationship to actor’s work meaningfulness and life well-being. Drawing on self-determination theory and affective events theory, we explore how exercising professional moral courage in (...) one’s work leads to positive work and life outcomes. Data from 106 administrative staff of non-profit organizations demonstrates the positive benefits of adopting ethical practices at work. Specifically, professional moral courage is found to be significantly related to both work meaningfulness and individual eudaimonic life well-being. Our findings note positive benefits for individuals who incorporate professional moral courage into their daily lives and provide support for organizations seeking to encourage it from their employees; benefits for organizations and employees go beyond just the gains from ethical behavior into other positive psychological processes. Implications for future work that considers both the psychological and normative approaches to meaningful work are discussed. (shrink)

Food production, water management, land use, and animal and public health are all topics of extensive public debate. These themes are linked to the core activities of the agricultural sector, and more specifically to the work of farmers. Nonetheless, the ethical discussions are mostly initiated by interest groups in society rather than by farmers. At least in Europe, consumer organizations and animal welfare and environmental organizations are more present in the public debate than farmers. This is not how it should (...) be. First, because consumers often cannot but rely on agriculture. Second, because recent research shows that farmers have moral beliefs and convictions that appear to be broader than economic considerations and that are—to a certain extent—specific to their profession. This raises the question how to make input from farmers operational in the public debates on the future of farming. We discuss one option: entrusting farmers with professional autonomy concerning moral matters related to farming. We sketch the historical background of the current situation in which farmers are relatively silent on moral matters and we present some clear indications that farmers have values and moral beliefs that are relevant for the public debate. Next the concepts of professionalism and professional autonomy are discussed and applied to the practice of farming. Finally, we discuss the relevance and limits of professional moral autonomy for the agricultural profession. We close with an overview of what this moral autonomy implies for and requires from farmers in practice. We conclude that if some preconditions are met by farmers, then this type of moral autonomy can be relevant for farmers and for society, and contributes to the quality of the public debate on the future of farming. (shrink)

Positive Psychology has turned its attention to the study of emotions in a scientific and rigorous way. Particularly, to how emotions influence people’s health, performance, or their overall life satisfaction. Within this trend, Flow theory has established a theoretical framework that helps to promote the Flow experience. Flow state, or optimal experience, is a mental state of high concentration and enjoyment that, due to its characteristics, has been considered desirable for the development of the performing activity of performing musicians. Musicians (...) are a population prone to health problems, both psychological and physical, owing to different stressors of their training and professional activity. One of the most common problems is Musical Performance Anxiety. In this investigation, an electronic intervention program was carried out for the development of psychological self-regulation skills whose main objective was to trigger the Flow response in performing musicians and the coping mechanism for Musical Performance Anxiety. A quasi-experimental design was used with a control group in which pre- and post-measures of Flow State, Musical Performance Anxiety and, also, Social Skills were taken. Sixty-two performing musicians from different music colleges in Spain participated in the program. Results indicated that the intervention significantly improved Flow State, and Sense of Control, and decreased Music Performance Anxiety, and self-consciousness of the participants in the EG but not CG. The changes in the EG after the program showed the inverse relationship between Flow and Anxiety. Two important theoretical factors of both variables, such as worry and the feeling of lack of control, could be involved. The results are under discussion and future lines of research are proposed. (shrink)

Background: The Measure of Moral Distress – Healthcare Professionals (MMD-HP) is a 27-item survey that quantifies moral distress. The MMD-HP was distributed to healthcare professionals (HPs), and analysis of a free-text response item revealed information-rich descriptions of morally distressing situations. Research question: What are HPs’ perceptions of their experiences of morally distressing situations? Research design: A descriptive, qualitative approach explored respondents’ free-text responses to the following open-ended response item: “If there are other situations in which you have felt moral distress, (...) please write and score them here.” Participants and research context: Eligible participants were HPs ( N = 8206) working in a large, multi-site healthcare system located in a major, urban city in the Southeastern United States. Ethical considerations: The Institutional Review Board provided approval for this research. A survey preamble supplied information, and consent was presumed with survey completion. Findings: Three themes were identified from 282 free-text responses: Theme 1: Compromised Quality of Care, Theme 2: Hostile Work Environment, and Theme 3: Ineffective Leadership. Conclusions: This study is unique because it provided in-depth qualitative analysis of morally distressing situations in a free-text response item across a wide array of HPs within multiple settings. Responses revealed that moral distress impacted the quality of patient care and provided descriptions of powerlessness to act. (shrink)

Background: In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient’s advance directives and implement them. Objectives: To analyse the barriers, facilitators, and ethical conflicts perceived by health professionals derived from the management of advance directives in emergency services. Research design, participants, and context: This is a qualitative phenomenological study conducted with purposive sampling including a population of nursing and medical professionals linked to Hospital Emergency Department and Emergency Medical (...) Services. Three focus groups were formed, totalling 24 participants. We performed an inductive-type thematic discourse analysis. Ethical considerations: This study was approved by ethical committees of Ethical Commitee of Clínic Hospital (Barcelona) and Comittee of Emergency Medical Services (Barcelona). The participants received information about the purpose of the study. Patients’ anonymity and willingness to participate in the study were guaranteed. Findings: There were four types of barriers that hindered the proper management of patients’ advance directives in Hospital Emergency Department and Emergency Medical Services: personal and professional, family members, organisational and structural, and those derived from the health system. These barriers caused ethical conflicts and hindered professionals’ decision-making. Discussion: These results are in line with those of previous studies and indicate that factors such as gender, professional category, and years of experience, in addition to professionals’ beliefs and the opinions of colleagues and family members, can also influence the professionals’ final decisions. Conclusion: The different strategies described in this study can contribute to the development of health policies and action protocols to help reduce both the barriers that hinder the correct management and implementation of advance directives and the ethical conflicts generated. (shrink)

In their upcoming article, Henk Jasper van Gils-Schmidt and Sabine Salloch highlight the supposed responsibilities of healthcare professionals in addressing the global health challenges posed by climate change. They argue that healthcare professionals’ duties to future generations and their ‘climate-related obligations’ have been neglected, primarily due to potential conflicts with other responsibilities, such as providing optimal care to current patients and maintaining patient trust. The authors suggest that these competing obligations should be viewed as part of the multifaceted identities individuals (...) hold, encompassing roles as both physicians and environmentalists, each with normative and competing commitments. They propose that a transformative shift in physicians’ professional ethos, expanding from the predominant focus on individual patients to include obligations towards climate protection, could pave the way for identifying effective mechanisms to address these challenges. While acknowledging the authors’ emphasis on sustainable healthcare practices, we argue that a duty to climate protection as part of healthcare professionals’ identity lacks ethical support. We identify serious concerns that stem from the transformative shift in physicians’ professional ethos, particularly in the authors’ presentation of reasons for action. First, envisaging a stable disposition that compels healthcare professionals to ensure optimal care conditions for both immediate and potential future encounters is unrealistic. Such a scenario would necessitate a nuanced and multifaceted evaluation, weighing …. (shrink)

Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...) only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim. (shrink)

Background Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses. Aim This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses. Research design Correlational, cross-sectional design following the STROBE guidelines. Participants and research context Convenience sampling was used (...) to recruit nurses ( n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses’ Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data. Ethical considerations The ethics review committee of a government university in Ha’il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured. Results The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue. Conclusion Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses. (shrink)

Healthcare professionals encounter many moral challenges in their daily clinical practice. However, there have been few studies on the subject matter in Tanzania. This study aims to provide an account of moral challenges faced by healthcare professionals in Tanzanian hospitals, their understanding of clinical ethics, and the ethics education they have received. Many participants reported receiving some kind of ethics training through formal education and on-the-job training. Some participants understood ethics in healthcare settings as adherence to established laws, regulations, guidelines, (...) procedures, norms, and rules essential in clinical practice. Analysis of the data identified four themes of moral challenges. These challenges are related to 1) decision-making and communication in clinical practice, 2) scarcity of medical resources and prioritization in clinical practice, 3) withdrawal of curative treatment, and 4) conflicts between professional judgment, religious convictions and adherence to alternative treatments. Based on the findings, we suggest a context-sensitive form of clinical ethics training to prepare healthcare professionals to recognize and address these moral challenges. (shrink)

Background Developing a framework that illustrates causal relationships and an in-depth comprehension of contextual elements is essential for steering the development of ethical interventions to enhance nurses’ ethical decision-making. Research aim To examine the relationship between cultural competence, professional nursing values, and moral sensitivities of surgical nurses with a mediation analysis and structural equation model. Research design This study is descriptive and correlational. Participants and research context: This study was conducted with a total of 201 surgical nurses from two (...) university hospitals in Konya, Türkiye. Data were gathered face-to-face between June and October 2023 with the Moral Sensitivity Questionnaire (MSQ), Nurses Professional Values Scale-Revised (NPVS-R), and Nurse Cultural Competence Scale (NCCS). Ethical considerations Ethical approval from Necmettin Erbakan University Ethics Committee was obtained (Number: 2023/419). Results In this study, the mean scores for the surgical nurses were as follows: 89.3 ± 19.33 on the MSQ, 113.1 ± 20.74 on the NPVS-R, and 72.06 ± 18.61 on the NCCS. Nurses’ cultural competence level significantly affected their professional nursing values (β = 0.192; p =.007; R2 = 0.04), and their professional nursing values, in turn, had a significant effect on their moral sensitivities (β = −0.363; p <.001; R2 = 0.16). However, it was determined that the direct effect of nurses’ cultural competence level on their moral sensitivity was not statistically significant. In contrast, the indirect effect of nurses’ cultural competence level on their moral sensitivity, mediated by their professional nursing values was seen to be statistically significant (B = −0.070; p =.008). Conclusions This study showed that there is a significant positive relationship between the professional nursing values and cultural competence levels of surgical nurses and that as professional nursing values increase, their moral sensitivity also rises. Sensitivity with higher professional nursing values. Additionally, it was found that nurses’ professional values served as a mediating factor between their levels of cultural competence and moral sensitivity. Therefore, it is crucial to enhance the cultural competence, professional nursing values, and moral sensitivity of nursing students and registered surgical nurses and to improve their reasoning and decision-making skills in ethical dilemmas. (shrink)

Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare (...) context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

This study compared professional and amateur classical musicians matched for age, gender, and education on reaction times during the Stroop color-word test, brainwaves during an auditory ERP task and during paired reaction-time tasks, responses on the Gibbs Sociomoral Reflection questionnaire, and self-reported frequencies of peak experiences. Professional musicians were characterized by: lower color-word interference effects , faster categorization of rare expected stimuli , and a trend for faster processing of rare unexpected stimuli , higher scores on the Sociomoral (...) Reflection questionnaire, and more frequent peak experiences during rest, tasks, and sleep. Both groups had high values on the Brain Integration Scale. These findings are interpreted in light of a Unified Theory of Performance, which posits that effectiveness in any area is influenced by one’s level of mind-brain development—emotional, cognitive, moral, ego and cortical development—with higher mind-brain development supporting greater effectiveness in any domain. (shrink)

Moral agency is an important constituent of the nursing role. We explored issues of ethical development in Greek nursing students during clinical practice at the beginning of their studies. Specifically, we aimed to explore students’ lived experience of ethics, and their perceptions and understanding of encountered ethical conflicts through phenomenological analysis of written narratives. The process of developing an awareness of personal values through empathizing with patients was identified as the core theme of the students’ experience. Six more common themes (...) were identified. Development of the students’ moral awareness was conceptualized as a set of stages, commencing with empathizing with patients and nurses, moving on to taking a moral stand and, finally, concluding by becoming aware of their personal values and showing evidence of an emerging professional moral personhood. The notions of empathy, caring and emotion were in evidence throughout the students’ experience. Implications for practice and nurse education are discussed. (shrink)

A central challenge motivates this work: How, if at all, can philosophical ethics help in the moral development of health professionals?

This books examines the fundamental values and principles of conduct in the professions, focusing specifically on four areas: law, politics, medicine and business. One central question unifies its inquiry into the different professions: should the principles for judging the actions of professionals be the same as those used to judge private individuals, or do these professions require special moral principles to guide their conduct. The author considers arguments deriving from the underlying institutional goals of each profession in turn.

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)

Philosophers, particularly moral philosophers, are increasingly being involved in public decision‐making in areas which are seen to raise ethical issues. For example, Dame Mary Warnock chaired the ‘Committee of Inquiry into Human Fertilization and Embryology’ in the UK in 1982–4; the Philosophy Department at Auckland was commissioned by the Auckland Regional Authority to report on the ethical aspects of fluoridating the public water supply in 1990; and many of us are serving on ethics committees of various sorts. Not only are (...) philosophers actually being called on or consulted, but many of us would argue that a philosophical contribution in such areas is essential.The involvement of moral philosophers in public policy decisions raises a question of professional ethics, viz, what role should a philosopher's own moral perspective or judgements play in the advice s/he gives, or contribution s/he makes, to public decision‐making on ethical issues. Like most problems in professional ethics, this prompts reflection on the nature of the profession, and in particular on the expertise we take moral philosophy to offer. It also prompts reflection on how processes of public decision making in ethically problematic areas should be understood. I explore these issues in this paper. (shrink)

When a severely suffering dying patient is deeply sedated, and this sedated condition is meant to continue until his death, the doctor involved often decides to abstain from artificially administering fluids. For this dual procedure almost all guidelines require that the patient should not have a life expectancy beyond a stipulated maximum of days (4–14). The reason obviously is that in case of a longer life-expectancy the patient may die from dehydration rather than from his lethal illness. But no guideline (...) tells us how we should describe the dual procedure in case of a longer life-expectancy. Many arguments have been advanced why we should not consider it to be a form of homicide, that is, ending the life of the patient (with or without his request). I argue that none of these arguments, taken separately or jointly, is persuasive. When a commission, even one that is not itself life-shortening, foreseeably renders a person unable to undo the life-shortening effects of another, simultaneous omission, the commission and the omission together should be acknowledged to kill her. I discuss the legal and ethical implications of this conclusion. (shrink)

In Professional Ethics and Civic Morals , Emile Durkheim outlined the core of his theory of morality and social rights which was to dominate his work throughout the course of his life. In Durkheim's view, sociology is a science of morals which are objective social facts, and these moral regulations form the basis of individual rights and obligations. This book is crucial to an understanding of Durkheim's sociology because it contains his much-neglected theory of the state as a (...) moral institution, and it provides an understanding of his critique of anomie and egoistic individualism. The growing interest in cultural revolution and moral regulation make this edition of Durkheim's classic work especially timely. The new preface by Bryan Turner sets the book in its intellectual and historical context, and illustrates the relevance of this work to present day debates on the state, society, and moral regulation. (shrink)

This paper exhorts geographers to become more active in debate about ethical research practice. It also suggests that ethical theory, practical problems, and lessons learned from postmodern thought make the prospects of establishing prescriptive codes of ethics unlikely. Instead, flexible prompts for moral contemplation might be used to encourage careful thought on matters of ethics. Because the practical feasibility of moral prompts rests on the existence of moral imaginations, it is vital to consider ways in which those imaginations might be (...) stimulated and nurtured. Professional associations and university academics have significant roles to play in this. Geographers must position themselves as effective agents in the processes by which professional research ethics are shaped rather than awaiting the potentially inappropriate outcomes of other agencies ' deliberations. (shrink)

Once anesthetized, patients are inherently “compliant” with surgical interventions because they can no longer intervene on their own behalf. In their target article, Minkoff et al. (2024) reasonabl...

The same person can make different moral judgments about the same activity in their professional role and in their personal life. For example, people may follow a different moral code when making purchases at work compared with in their private lives. This potential difference has largely remained unexamined. This study explores differences in felt moral responsibility in workplace and private purchasing settings, regarding the impacts of purchasing decisions on supply chain workers, and explores the influence of personal values and (...) ethical work climate. The case of a high-profile university in the United Kingdom is studied, which has made strong commitments to socially responsible public procurement. Based on a survey of 318 university staff who make purchases at work, stronger moral values related to harm/care are associated with higher felt responsibility in personal purchasing than in workplace purchasing, whereas less strong harm/care values are associated with higher felt responsibility in workplace purchasing than personal purchasing. In relation to ethical work climate, detailed awareness of organizational ethical procurement commitments is found to be associated with higher felt responsibility in workplace purchasing and is also found to increase the discrepancy between workplace and personal felt responsibility, increasing felt responsibility in the workplace but not in personal purchasing. These findings demonstrate the influence of individual and contextual factors on felt responsibility across different roles. Recommendations are made for further empirical research on felt responsibility across roles and additional internal communication on social responsibility for devolved public procurement contexts. (shrink)

Background Encounters of moral distress have long-term consequences on healthcare workers’ physical and mental health, leading to job dissatisfaction, reduced patient care, and high levels of burnout, exhaustion, and intentions to quit. Yet, research on approaches to ameliorate moral distress across the health workforce is limited. Research Objective The aim of our study was to qualitatively explore multi-professional perspectives of healthcare social workers, chaplains, and patient liaisons on ways to reduce moral distress and heighten well-being at a southern U.S. (...) academic medical center. Participants & Research Context Purposive sampling and chain-referral methods assisted with recruitment through hospital listservs, staff meetings, and newsletters. Interested participants contacted the principal investigator and all interviews were conducted in-person. Consent was attained prior to interviews. All interviews were recorded and transcribed verbatim. Research Design Directed content analysis was used to deductively organize codes and to develop themes in conjunction with the National Academy of Medicine’s National Plan for Health Workforce Well-Being. Rigor was attained through peer-debriefing, data triangulation methods, and frequent research team meetings. Ethical Considerations Ethics approval was obtained from the university and medical center institutional review boards. Findings Themes demonstrate that rather than offering interventions in the aftermath of moral distress, multilevel daily practices ought to be considered that pre-emptively identify and reduce morally distressing encounters through (1) the care team, (2) management and leadership, and (3) the health care industry. Strategies include interdisciplinary decision-making, trusting managerial relationships, and organizational policies and practices that explicitly invest in mental health promotion and diverse leadership opportunities. Conclusion Moral distress interventions ought to target short-term stress reactions while also addressing the long-term impacts of moral residue. Health systems must financially commit to an ethical workplace culture that explicitly values mental health and well-being. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in (...) long-term care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were (...) interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

Abstract:A marketplace of morality (MOM) is a place where individuals act under the influence of their moral desires. A MOM produces an output representing the aggregate acted-upon moral preferences of its participants. Individual behavior is influenced by POPs, or passions of propriety. People implement POP preferences when they buy stock, purchase goods and services, choose jobs and so on. Firms respond by social cause marketing and other devices which encourage customers to align their social preferences with those represented by (...) the firm. The outputs of MOM constitute an important reference point for understanding business morality. Even so, the normative status of MOM outputs must be subject to principles of universal morality. A principle of greater preponderance is offered as a means for determining when a MOM output is ethically legitimate.A theory of moral choice, based upon the concept of a MOM, may have potential for providing a unifying framework integrating moral preferences, reasoning, behaviors and organizational contexts with broader political and economic concepts. (shrink)

Se realizó una investigación en sistemas y servicios de salud de tipo descriptiva transversal, con el objetivo de elaborar un sistema de acciones de capacitación para el profesional de la enfermería comunitaria en la prevención del embarazo en la adolescencia. Se aplicaron métodos teóricos y empíricos propios de la investigación científica. El universo lo constituyeron 20 profesionales de enfermería que laboran en consultorios del Área Salud "Tula Aguilera". La muestra quedó conformada por los 12 profesionales que aceptaron participar en el (...) estudio. El criterio de exclusión fue la libre decisión de cada individuo para participar o retirarse de la investigación. Se aplicó una encuesta estandarizada, previo consentimiento informado, para determinar el nivel de conocimientos sobre salud reproductiva en la adolescencia. Los resultados constatados reflejaron que la mayoría de los encuestados tenían criterios estrechos, no fundamentados científicamente ni actualizados sobre el tema, por lo que se diseñó un sistema de acciones de capacitación basado en conocimientos científicos actualizados, pertinentes y contextualizados. Cada actividad se propuso demostrar la factibilidad e importancia de utilizar técnicas participativas y la fundamentación de las ventajas de su uso en diferentes actividades comunitarias, encaminadas a enfatizar en la organización, movilización, concientización y capacitación a los diferentes sujetos sociales involucrados en la prevención del embarazo en la adolescencia, para que estos se conviertan en transformadores de su propia realidad, en correspondencia con sus necesidades y demandas sociales. A descriptive transversal study was carried out on health systems and services aiming at designing a system of training actions for the community professional nurses in order to prevent pregnancy in adolescence. Theorical and empirical methods were applied. The universe was made up of twenty professionals who consented to participate in the study. The inclusion criterion was the free decision of each individual on either participating or not in the investigation. A standard survey was applied -with a previous informed consent , to determine the knowledge about reproductive health in adolescence. The results revealed that most of the surveyed people had narrow criteria with no updated scientific grounds on the issue, thus a system of training actions based on updated scientific pertinent contextualized information was designed Each activity aimed at demonstrating the feasibility study of using participative techniques as well as the reasons for the advantages of their use in a variety of community activities to emphasize the organization and understanding of the different social subjects involved in the prevention of pregnancy in adolescence. (shrink)

ABSTRACT Through an interdisciplinary literature review, this propositional paper explores the emergence and unfolding of professionals’ moral identity conflicts involving important but contrasting values. Building on the exemplary case of physicians’ professional-religious dilemmas in End-of-Life circumstances, we develop a multilevel model of professional-personal identity conflict dynamics in ethically-charged situations in which we integrate individual-level mechanisms with organizational-level boundary conditions, namely peer social support and ethical climate, in relation to psychological well-being. Our conceptual model contributes to the ethics, identity (...) and human behavior literature by advancing suggestions of how professionals may prevent or/and resolve moral conflicts concerning also other identities and contexts. (shrink)

Modern educational thoughts have made a powerful impact on civilized persons. The learner is a partner in the process of learning in our age. He is a disciple and is going to be a consumer as well as customer. There is a shift from education as a means of welfare and awareness to commercialization of education. In this background, Professional Ethics is partly comprised of what a professional should or should not do in the work -place. It also (...) encompasses a much greater part of the professional’s life. If a professional is to have ethics then that person needs to adopt that conduct in all of his dealings. Another aspect of this is the enhancement of the profession and the industry within which the professional works. It concerns a professional’s conduct and behaviour while carrying out their professional work that is work for the good of the community and mankind. In this paper it is an attempt to draw out a relation between Professional Ethics and Morality. (shrink)

While qualities of good character are of great significance and value in human social and professional affairs—and conduct which at least conforms to such qualities is invariably required for public service employment—they cannot be a requirement of the private lives of citizens in free societies. That said, there seems more of a case for the personal possession of such qualities in the case of those human professions and services for which moral exemplification to others may be considered an inherent (...) part of the professional role. After some consideration of arguments for and against such moral character exemplification in relation to such professional roles as religious ministry and teaching, this paper proceeds to make some case for politics as professional role of this exemplificatory kind. (shrink)

Western civilization has probably reached an impasse, expressed as a crisis on all fronts: economic, technological, environmental and political. This is experienced on the cultural level as a moral crisis or an ethical deficit. Somehow, the means we have always assumed as being adequate to the task of achieving human welfare, health and peace, are failing us. Have we lost sight of the primacy of human ends? Governments still push for economic growth and technological advances, but many are now asking: (...) economic growth for what, technology for what? Health care and nursing are caught up in the same inversion of human priorities. Professionals, such as nurses and midwives, need to take on social responsibilities and a collective civic voice, and play their part in a moral regeneration of society. This involves carrying civic rights and duties into the workplace. (shrink)

Modern professional behavior all too often fails to meet high standards of moral conduct. An important reason for this unfortunate state of affairs is the expansive self interest of the individual professional. The individual''s natural desire for his/her own success and pleasure goes unchecked by internal moral constraints. In this essay, I investigate this phenomenon using the psychoanalytic concepts of the ego ideal and superego. These concepts are used to explore the internal psychological dynamics that contribute to moral (...) decision-making. The contrasts between self interest and concern for others, selfishness and moral values, and moral conscience and social conformity are examined in Tolstoy''s study of the modern professional in The Death of Ivan Ilych. By reviewing Freud''s work on the moral conscience, particularly its complex inner structure and liabilities to dysfunction, and applying it to Tolstoy''s penetrating portrayal of Ivan Ilych''s personal and professional life, an understanding of the inner (emotional) foundation of moral character, its dependence on the past through the links between generations, and the need to integrate idealism with moral values is generated. Examples from Enron Corporation will be used throughout the paper to relate the analysis and discussion to contemporary business ethics problems. (shrink)

We examined the effects of order of presentation on the moral judgments of professional philosophers and two comparison groups. All groups showed similar-sized order effects on their judgments about hypothetical moral scenarios targeting the doctrine of the double effect, the action-omission distinction, and the principle of moral luck. Philosophers' endorsements of related general moral principles were also substantially influenced by the order in which the hypothetical scenarios had previously been presented. Thus, philosophical expertise does not appear to enhance the (...) stability of moral judgments against this presumably unwanted source of bias, even given familiar types of cases and principles. (shrink)