Moral Sensitivity of Young People with Intellectual Disability – Its Role in The Process of Their Education

According to Heller and Życiński (1980) the primary regulator of human behaviour is the system of values therefore its development should be in the centre of all educational and upbringing measures. Our focus here is on moral sensitivity understood as the ability of an individual to see social situations from the perspective of moral good and moral evil that represent values embodied in moral norms adopted by the world and internalised by humans as the principles of conduct. The main research question was the following: How morally sensitive are persons with ID and how is their sensitivity associated with the degree of intellectual disability and gender? A non-probability sample 267 of Polish residents aged 16-30 years with mild (58.42%) or moderate (41.58%) intellectual disability was assembled. Men and women were almost in equal proportion. The Moral Sensitivity Inventory (MSI; Otrębski, Sudoł, 2020) has been used to measure the moral sensitivity of people with ID. It consists of 10 illustrated stories presenting typical social situations containing moral dilemmas, and an evaluation form. The tested person’s task is to answer the following question “Who, in this story, did something right or wrong, and what was that?” and to indicate as many moral elements in the story and the picture as they can. The results imply that the study participants had different ability to discern moral good and moral evil. They were more sensitive to the manifestations of good and evil bad associated with Understanding one’s behaviour and its impact on others (more than one-fourth of them had high scores) and less perceptive of those relating to Respect for others’ property and Conformance to principles and norms. The results of the study expand the knowledge of the overall moral sensitivity of persons with intellectual disabilities.

Good Science

Good Science is an account of psychological research emphasizing the moral foundations of inquiry. This volume brings together existing disciplinary critiques of scientism, objectivism, and instrumentalism, and then discusses how these contribute to institutionalized privilege and to less morally responsive research practices. The author draws on historical, critical, feminist, and science studies traditions to provide an alternative account of psychological science and to highlight the irreducibly moral foundations of everyday scientific practice. This work outlines a theoretical framework for thinking about and practicing psychology in ways that center moral responsibility, collective commitment, and justice. The book then applies this framework, describing psychological research practices in terms of the their moral dilemmas. Also included are materials meant to aid in methods instruction and mentoring.

‘Others Will Even Call us Terminators’: Barriers and Facilitators to Provision of Comprehensive Abortion Care (Cac) in Zambia – A Qualitative Study

Background:It is estimated that one in every five pregnancies globally ends up as abortion, with about 40% being unsafe. Abortions account for approximately 5.9% of all maternal mortalities and 50% of gynaecological admissions in Zambia. Despite implementing Comprehensive Abortion Care (CAC), which aims to provide high quality, safe and affordable services to women, unsafe abortions rates remain high. In this study, we explored the barriers and facilitators to CAC provision in selected health facilities of Lusaka and Copperbelt provinces in Zambia.Materials and methods: A qualitative case study using in-depth interviews with health care providers was conducted between July – August, 2021 in nine selected public health facilities of Zambia. A total of 17 interviews were conducted with participants purposively sampled. The interviews were digitally recorded and transcribed verbatim. Data analysis was done using content analysis. Results: The study revealed a number of barriers and facilitators most of which are health system related. The health system related barriers included inadequate CAC providers, healthcare provider perception that provision of CAC was optional, lack of CAC dedicated space and privacy, frequent shortages of medical supplies and lack of incentives, while individual related barriers included stigma surrounding CAC provision, religious and moral dilemmas. Facilitators to CAC provision included having providers trained and mentored in CAC, availability of a liberal legal framework, accessible services, task shifting and external financial support. Conclusions: The findings of this study on the several barriers of CAC reinforces the idea that despite having appropriate legal provisions to CAC provision in Zambia, challenges in the implementation of the law and related service provision continue to persist. The identified barrriers suggests to consider incorporating CAC services into the pre-service training to ensure more trained and skilled providers are available in the public facilities.

Professional moral courage and moral reasoning among nurses in clinical environments: a multivariate model

Improving ethical practice needs recognizing the relationship between moral reasoning and moral courage among nurses. We examined factors (moral reasoning, practical consideration, moral dilemmas familiarity, and demographic and work characteristics) associated with moral courage among nurses. A cross-sectional design was run at all five hospitals affiliated to Hamadan University of Medical Sciences in west of Iran. A proportionate random sampling due to the total size of the nurse population in each hospital, 224 eligible nurses were completed the study questionnaires: demographic-work characteristics, Professional Moral Courage (PMC), and Nursing Dilemma Test. The relationships were examined by multiple regression analysis. Participants reported a more than moderate level of moral reasoning and PMC (43.21±5.98 and 56.16±10.18 respectively). The multivariate model showed the nurses’ PMC is positively predisposed with moral reasoning (β=0.21, p<0.01), but negatively with practical consideration (β=-0.16, p<0.01). More moral courage was found in the nurses who were never married (p<0.001), graduated from a public university (p<0.01), working in the critical care and emergency environments, as well as night shifts (all p<0.001). Moral reasoning is a predictor of moral courage, and both should be considered in designing nursing education to improve ethical nursing practice.

The Archangel Delusion. Descriptive Ethics and Its Role in the Education of Ethicists

The role of ethicists is to provide a genuine ethical theory to help non-ethicists interpret and solve moral dilemmas, to define what is right or wrong, and, finally, to clarify moral values. Therefore, ethicists are taught to address morality with rational procedures, to set aside their moral intuitions and emotions. Sometimes, professional ethicists are prone to falling into the archangel delusion – the belief that they are beyond the influence of their own emotions. This can lead to ousting moral intuitions from the space of ethical reflection, thus making ethicists unaware of them. They may treat intuitive beliefs about morality as an expression of primal moral feelings. The main question pursued in this article, is how those feelings may influence moral theories, which should be developed by professional ethicists. Ethicists may provide an ethical theory which is merely a rationalisation and justification for their own suppressed moral emotions, rather than the effect of genuine, rational moral reasoning. To help ethicists cope with this delusion, a model of cooperation between descriptive and normative ethics is proposed. Ethicists should therefore use the research tools of descriptive ethics to determine their own intuitions, and the moral emotions in which these intuitions are grounded. --------------- Received: 09/06/2021. Reviewed: 23/07/2021. Accepted: 13/08/2021.

A Qualitative Exploration of Medical Student Empathy During the COVID-19 Pandemic

BackgroundThere is evidence that medical student self-reported empathy may decline as one progresses through their clinical training. Due to the unprecedented changes to both patient care and medical education caused by COVID-19, it is reasonable to assume that medical student empathy may be impacted. The goal of this July 2020 study was to qualitatively explore how the COVID-19 pandemic might affect medical students’ reported experience of empathy.MethodUsing a semi-structured interview, the authors interviewed 12 medical students, 6 second-year and 6 fourth-year. They selected these groups because of the distinct differences in their clinical experience. ResultsData analysis identified 5 major themes: 1) Expanded Perspective (e.g., a feeling of “we’re in this together”, increased awareness of patient vulnerability) 2) Moral Dilemmas (e.g., difficult decisions faced by students as a result of the pandemic such as weighing educational vs. family responsibilities, students risking their own health to provide the best possible care) 3) Confirmation of Values (e.g., Feeling reaffirmed in decision to enter medicine, feeling the pandemic was “what we signed up for” by entering medical school) 4) Shaping Priorities (e.g., changes in medical specialty or populations of interest) 5) Barriers to Empathy and Adaptive Strategies (e.g., COVID-19 created many physical, psychological, and social barriers to empathy for students, students presented many strategies for ameliorating these barriers). Five students (42%) reported increased empathy with no students reporting a decrease in empathy due to experiences during the pandemic. Conclusions Participants did not report that their personal experience of empathy for patients was negatively influenced by the COVID-19 pandemic. Many reported that their empathy increased. The observed differences in responses by pre-clinical (second-year) and clinical (fourth-year) students suggests a possible shift in how empathy is experienced and practiced as one progresses through their medical education. The overwhelmingly positive responses to the semi-structured interview, emphasizing appreciation of the opportunity to discuss topics not previously openly discussed, underscores the importance of providing explicit opportunities for students to discuss their emotional/interpersonal experiences within medical education, particularly in difficult times such as the COVID-19 pandemic.

Self-protective and self-sacrificing preferences of pedestrians and passengers in moral dilemmas involving autonomous vehicles

Upon the introduction of autonomous vehicles into daily traffic, it becomes increasingly likely that autonomous vehicles become involved in accident scenarios in which decisions have to be made about how to distribute harm among involved parties. In four experiments, participants made moral decisions from the perspective of a passenger, a pedestrian, or an observer. The results show that the preferred action of an autonomous vehicle strongly depends on perspective. Participants’ judgments reflect self-protective tendencies even when utilitarian motives clearly favor one of the available options. However, with an increasing number of lives at stake, utilitarian preferences increased. In a fifth experiment, we tested whether these results were tainted by social desirability but this was not the case. Overall, the results confirm that strong differences exist among passengers, pedestrians, and observers about the preferred course of action in critical incidents. It is therefore important that the actions of autonomous vehicles are not only oriented towards the needs of their passengers, but also take the interests of other road users into account. Even though utilitarian motives cannot fully reconcile the conflicting interests of passengers and pedestrians, there seem to be some moral preferences that a majority of the participants agree upon regardless of their perspective, including the utilitarian preference to save several other lives over one’s own.