Veterinary Student Opinions Regarding Ethical Dilemmas Encountered by Veterinarians and the Benefits of Ethics Instruction.

Recognizing and addressing ethical conflicts is an emerging concern for veterinarians. Veterinary students (N = 284) from four US schools were surveyed regarding their opinions on ethical dilemmas encountered by veterinarians and the benefits of ethics instruction. The majority of respondents had encountered all clinical scenarios that may be associated with ethical dilemmas that were provided. The most common ethical dilemma experienced was compromise of patient care because of financial limitations. Students with at least 12 months of experience were more likely to believe that practitioners encounter ethical dilemmas regularly. Although 92% of 271 respondents indicated that veterinarians should prioritize patient interests when the interests of clients and patients conflict, 84% of respondents reported that veterinarians most often prioritize client interests. Most (78%) respondents indicated having received training in ethical theories and approaches to address ethical dilemmas. The majority of respondents agreed that they feel better prepared to identify (80%) and address (55%) ethical dilemmas as a result of their ethics training. Most respondents (81%) identified experiencing moral stress in relation to how animals were treated. Only 46% of respondents reported receiving training in tools for coping with moral stress. Most of these respondents (54%) agreed that such training would be effective in helping to manage moral stress. Results suggested that educators should prepare students for the contrast in advocacy preferences they are apt to encounter when they enter practice. It is recommended that ethics training and tools for coping with moral stress be core components of the veterinary curriculum.

Moral courage and psychological empowerment among nurses.

BACKGROUND: Moral courage is one of the fundamental values of nursing profession and a powerful method of coping with ethical problems. Psychological empowerment is a suitable method of enabling individuals to coping mental pressures of the work environment. This study determined the correlation between moral courage and psychological empowerment of nurses. METHODS: This was a descriptive cross-sectional study. A total of 180 nurses employed in different wards were selected randomly. Data were collected by Demographics Questionnaire, Sekerka's Moral Courage Scale, and Spreitzer's psychological empowerment Scale and analyzed with SPSS16 using descriptive and inferential statistics. FINDINGS: The results indicated that the mean score of moral courage was 21.11 ± 69.90 and the greatest amount of moral courage was in the dimension of "going beyond compliance". The mean score of "psychological empowerment" was 30.9 ± 73.58 and the greatest mean belonged to "competence". There was a positive significant correlation between "psychological empowerment" and "moral courage and its dimensions" (P < 0.05). CONCLUSION: The findings suggested a correlation between moral courage and psychological empowerment. Thus, nurses' moral courage could be enhanced by reinforcing their psychological empowerment leading to increased patient satisfaction and quality care.

Care situations demanding moral courage: Content analysis of nurses' experiences.

BACKGROUND: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients' safety or their good care. However, there is lack of research of moral courage. PURPOSE: This study describes nurses' experiences of care situations demanding moral courage and their actions in these situations. METHOD: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation of the Nurses' Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis. ETHICAL CONSIDERATIONS: The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee. FINDINGS: Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action. CONCLUSION: Care situations demanding moral courage focus on good and safe patient care and the patient's good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients' and their relatives' experiences of care situations demanding moral courage.

Comparison of the Moral Sensitivity, Judgment, and Actions of Australian and Turkish Veterinary Students in Relation to Animal Ethics Issues.

Veterinarians regularly face animal ethics conflicts, and research has identified the moral reasoning methods that they utilize to solve these. It is unclear whether students' sensitivity to animal ethics conflicts influences their reasoning methods, and the recent development of appropriate tests allows this to be assessed. We compared the moral reasoning methods, intended action and sensitivity of 112 first-year veterinary students in two contrasting veterinary schools, in Australia and Turkey. Students were presented with two animal ethics issues: breeding blind hens to address welfare concerns in intensive housing, for moral reasoning evaluation; and a video of a lame dairy cow walking, for sensitivity assessment. The sensitivity score was not related to the principal moral reasoning methods, which are Personal Interest (PI), Maintaining Norms (MN), and Universal Principles (UP). However, less sensitive students were more concerned about professional criticism of emotional reactions when addressing the hen scenario. Turkish students, mostly males, used more MN reasoning when deciding the hen dilemma. Australian, mostly female, students did not. Overall, female students were more likely to consider the universal moral principles in moral reasoning than male students and were more likely to recommend against breeding blind hens. This suggests that females are more likely to consider the ethical implications of their actions than males. This study demonstrates relationships between ethical sensitivity (ES) and moral reasoning, and cultural and gender effects on moral action choices. Students placing greater importance on professional criticism about having an emotional reaction are more likely to be those who have less ES.

Alcohol, empathy, and morality: acute effects of alcohol consumption on affective empathy and moral decision-making.

RATIONALE: Hypothetical moral dilemmas, pitting characteristically utilitarian and non-utilitarian outcomes against each other, have played a central role in investigations of moral decision-making. Preferences for utilitarian over non-utilitarian responses have been explained by two contrasting hypotheses; one implicating increased deliberative reasoning, and the other implicating diminished harm aversion. In recent field experiments, these hypotheses have been investigated using alcohol intoxication to impair both social and cognitive functioning. These studies have found increased utilitarian responding, arguably as a result of alcohol impairing affective empathy. OBJECTIVES: The present research expands existing investigations by examining the acute effects of alcohol on affective empathy and subsequent moral judgments in traditional vignettes and moral actions in virtual reality, as well as physiological responses in moral dilemmas. METHODS: Participants (N = 48) were administered either a placebo or alcohol in one of two dosages; low or moderate. Both pre- and post intervention, participants completed a moral action and moral judgment task alongside behavioural measures of affective empathy. RESULTS: Higher dosages of alcohol consumption resulted in inappropriate empathic responses to facial displays of emotion, mirroring responses of individuals high in trait psychopathy, but empathy for pain was unaffected. Whilst affective empathy was influenced by alcohol consumption in a facial responding task, both moral judgments and moral actions were unaffected. CONCLUSIONS: These results suggest that facets, beyond or in addition to deficits in affective empathy, might influence the relationship between alcohol consumption and utilitarian endorsements.

The Relationship between Intuitive Action Choices and Moral Reasoning on Animal Ethics Issues in Students of Veterinary Medicine and Other Relevant Professions.

With growing understanding of animals' capabilities, and public and organizational pressures to improve animal welfare, moral action by veterinarians and other relevant professionals to address animal issues is increasingly important. Little is known about how their action choices relate to their moral reasoning on animal ethics issues. A moral judgment measure, the VetDIT, with three animal and three non-animal scenarios, was used to investigate the action choices of 619 students in five animal- and two non-animal-related professional programs in one Australian university, and how these related to their moral reasoning based on Personal Interest (PI), Maintaining Norms (MN), or Universal Principles (UP) schemas. Action choices showed significant relationships to PI, MN, and UP questions, and these varied across program groups. Having a previous degree or more experience with farm animals had a negative relationship, and experience with horses or companion animals a positive relationship, with intuitive action choices favoring life and bodily integrity of animals. This study helps to explain the complex relationship between intuitive moral action choices and moral reasoning on animal ethics issues. As a useful research and educational tool for understanding this relationship, the VetDIT can enhance ethical decision making.

Virtual morality in the helping professions: Simulated action and resilience.

Recent advances in virtual technologies have allowed the investigation of simulated moral actions in aversive moral dilemmas. Previous studies have employed diverse populations to explore these actions, with little research considering the significance of occupation on moral decision-making. For the first time, in this study we have investigated simulated moral actions in virtual reality made by professionally trained paramedics and fire service incident commanders who are frequently faced with and must respond to moral dilemmas. We found that specially trained individuals showed distinct empathic and related personality trait scores and that these declined with years of experience working in the profession. Supporting the theory that these professionals develop resilience in moral conflict, reduced emotional arousal was observed during virtual simulations of a distressing dilemma. Furthermore, trained professionals demonstrated less regret following the execution of a moral action in virtual reality when compared to untrained control populations. We showed that, contrary to previous research, trained individuals made the same moral judgements and moral actions as untrained individuals, though showing less arousal and regret. In the face of increasing concerns regarding empathy decline in health care professionals, we suggest that the nature of this decline is complex and likely reflects the development of a necessary emotional resilience to distressing events.

The Relationship between Intuitive Action Choices and Moral Reasoning on Animal Ethics Issues in Students of Veterinary Medicine and Other Relevant Professions.

With growing understanding of animals' capabilities, and public and organizational pressures to improve animal welfare, moral action by veterinarians and other relevant professionals to address animal issues is increasingly important. Little is known about how their action choices relate to their moral reasoning on animal ethics issues. A moral judgment measure, the VetDIT, with three animal and three non-animal scenarios, was used to investigate the action choices of 619 students in five animal- and two non-animal-related professional programs in one Australian university, and how these related to their moral reasoning based on Personal Interest (PI), Maintaining Norms (MN), or Universal Principles (UP) schemas. Action choices showed significant relationships to PI, MN, and UP questions, and these varied across program groups. Having a previous degree or more experience with farm animals had a negative relationship, and experience with horses or companion animals a positive relationship, with intuitive action choices favoring life and bodily integrity of animals. This study helps to explain the complex relationship between intuitive moral action choices and moral reasoning on animal ethics issues. As a useful research and educational tool for understanding this relationship, the VetDIT can enhance ethical decision making.

Faultless responsibility: on the nature and allocation of moral responsibility for distributed moral actions.

The concept of distributed moral responsibility (DMR) has a long history. When it is understood as being entirely reducible to the sum of (some) human, individual and already morally loaded actions, then the allocation of DMR, and hence of praise and reward or blame and punishment, may be pragmatically difficult, but not conceptually problematic. However, in distributed environments, it is increasingly possible that a network of agents, some human, some artificial (e.g. a program) and some hybrid (e.g. a group of people working as a team thanks to a software platform), may cause distributed moral actions (DMAs). These are morally good or evil (i.e. morally loaded) actions caused by local interactions that are in themselves neither good nor evil (morally neutral). In this article, I analyse DMRs that are due to DMAs, and argue in favour of the allocation, by default and overridably, of full moral responsibility (faultless responsibility) to all the nodes/agents in the network causally relevant for bringing about the DMA in question, independently of intentionality. The mechanism proposed is inspired by, and adapts, three concepts: back propagation from network theory, strict liability from jurisprudence and common knowledge from epistemic logic.This article is part of the themed issue 'The ethical impact of data science'.

Critical thinking, nurse education and universities: some thoughts on current issues and implications for nursing practice.

When in the latter part of the 20th century nurse 'training' in the UK left the old schools of nursing (based within the health delivery system) and entered universities, the promise was not just a change of focus from training to education but an embracement of 'higher' education. Specifically, nurses were to be exposed to the demands of thinking rather than just doing - and critical thinking at that. However, despite a history of critical perspectives informing nursing theory, that promise may be turning sour. The insidious saturation of the university system in bureaucracy and managerialism has, we argue, undermined critical thinking. A major funding restructuring of higher education in the UK, coinciding with public concern about the state of nursing practice, is undermining further the viability of critical thinking in nursing and potentially the acceptability of university education for nurses. Nevertheless, while critical thinking in universities has decayed, there is no obvious educational alternative that can provide this core attribute, one that is even more necessary to understand health and promote competent nursing practice in an increasingly complex and globalising world. We propose that nurse academics and their colleagues from many other academic and professional disciplines engage in collegiate 'moral action' to re-establish critical thinking in UK universities.

Juízo e ação moral: desafios teóricos em psicologia / Judgment and moral action: theoretic challenges in psychology

O presente artigo apresenta e discute a polêmica, no campo da psicologia moral, sobre as relações entre juízo e ação. Teorias de tradição racionalista e estruturalista, como as de Piaget e Kohlberg, afirmam uma relação de continuidade entre juízo e ação moral e, ao mesmo tempo, lançam pontos de discussão sobre a complexidade envolvida no tema. Por outro lado, novas frentes de trabalho sugerem a integração de outros elementos (a cultura, a afetividade e o self), além das estruturas que podem compor um referencial com o qual se evidenciem as relações entre os aspectos envolvidos nas condutas morais. Por fim, apesar das críticas acenarem com caminhos promissores na pesquisa sobre o juízo e a ação moral, ainda existem limites na construção de referenciais teóricos e metodológicos que articulem diferentes perspectivas de análise psicológica da moralidade.

The attending article presents and discusses the debate within the cognitive constructivist theories, which have as main representatives Jean Piaget and Lawrence Kohlberg. Such theories of rationalist and structuralist tradition maintain continuity between judgment and moral action and, at the same time, launch points of discussion on the complexity involved in the theme. New work fronts suggest the integration of other elements: culture, affectionateness, and the self, beyond the structures that may compound a referential that explains the relations between the aspects involved in moral behavior. Lastly, despite the criticism indicating a promising path in the search about judgment and moral action, considering its complex character, there are still limits in the making of the theoretical and methodological frameworks that articulate different perspectives of moral psychological analyses.

Juízo e ação moral: desafios teóricos em psicologia / Judgment and moral action: theoretic challenges in psychology

O presente artigo apresenta e discute a polêmica, no campo da psicologia moral, sobre as relações entre juízo e ação. Teorias de tradição racionalista e estruturalista, como as de Piaget e Kohlberg, afirmam uma relação de continuidade entre juízo e ação moral e, ao mesmo tempo, lançam pontos de discussão sobre a complexidade envolvida no tema. Por outro lado, novas frentes de trabalho sugerem a integração de outros elementos (a cultura, a afetividade e o self), além das estruturas que podem compor um referencial com o qual se evidenciem as relações entre os aspectos envolvidos nas condutas morais. Por fim, apesar das críticas acenarem com caminhos promissores na pesquisa sobre o juízo e a ação moral, ainda existem limites na construção de referenciais teóricos e metodológicos que articulem diferentes perspectivas de análise psicológica da moralidade.(AU)

The attending article presents and discusses the debate within the cognitive constructivist theories, which have as main representatives Jean Piaget and Lawrence Kohlberg. Such theories of rationalist and structuralist tradition maintain continuity between judgment and moral action and, at the same time, launch points of discussion on the complexity involved in the theme. New work fronts suggest the integration of other elements: culture, affectionateness, and the self, beyond the structures that may compound a referential that explains the relations between the aspects involved in moral behavior. Lastly, despite the criticism indicating a promising path in the search about judgment and moral action, considering its complex character, there are still limits in the making of the theoretical and methodological frameworks that articulate different perspectives of moral psychological analyses.(AU)

Commentary - chronic moral distress among childbirth educators: is there a cure?

Childbirth educators who express frustration with the perceived lack of power in their practice may be suffering from moral distress. Although the impact of moral distress has not been thoroughly explored among health-care professionals, the topic is emerging as an important ethical concept. In this article, the concept of moral distress is explored, and suggestions are made for moving from moral distress to moral action.