Moral Dilemmas Research Articles

Factors associated with moral sensitivity among nurses in adult intensive care units: A cross-sectional study in China.

Moral sensitivity may play a role in dealing with ethical issues in ICUs. However, the moral sensitivity of adult ICU nurses in China and its predictors have not been well investigated. To analyse the moral sensitivity of intensive care unit (ICU) nurses and its predictors. A cross-sectional study through convenience sampling was conducted in the ICUs of five hospitals in China between November and December 2022. A total of 331 ICU nurses were recruited. Data were obtained using a self-developed socio-demographic characteristic questionnaire, the Moral Sensitivity Questionnaire, the Jefferson Scale of Empathy-Health Professionals and the Organizational Climate Scale for Nursing. The participating institutions received a link to the tools used for online data collection, which they then forwarded to nursing staff. The valid response rate was 96.98% (n = 321). The total mean moral sensitivity score of nurses was 43.04 ± 5.95. The mean scores for empathic ability and organizational climate for nursing were 91.97 ± 17.88 and 101.28 ± 14.77, respectively. Regression analyses revealed that the primary factors associated with moral sensitivity among critical care nurses included work tenure (p < .05), empathic ability (p < .001) and organizational climate (p < .001). High levels of moral sensitivity were found in critical care nurses in China. Work tenure, empathic ability and organizational climate were significant predictors of moral sensitivity in critical care nurses. To enhance the ethical sensitivity of ICU nurses, we suggest to strengthen the training of novice nurses so that they can better face the moral dilemma in clinical practice. In addition, organizational managers should also take measures to create a positive and harmonious working atmosphere, promote the application of moral knowledge in nursing practice and enhance their moral sensitivity.

A spiking neuron model of moral judgment in trolley dilemmas

People will make different moral judgments in similar moral dilemmas where one can act to sacrifice some number of lives to save several more. Research has shown that although people can reason that an action would save more lives, automatic processes can overwrite deliberate reasoning. Having participants imagine hypothetical moral dilemmas, researchers have discovered that factors such as action/omission, means/side-effect, and personal/impersonal can affect judgment. Joshua Greene suggests that these features do not affect people’s judgment because they are morally relevant but are instead a result of the myopic nature of the automatic moral process. Greene hypothesizes that there is some myopic module or domain-general process that attaches a negative emotional response to an action when one is contemplating violent actions. In the present research a model of this myopic automatic process is paired with an analytic system to replicate deontological and utilitarian responses to moral dilemmas. Our system, MERDJ, models this in simulated spiking neurons. The system takes in representations of specific moral dilemmas as inputs and outputs judgments of appropriate or inappropriate.

Staging Conscience

Through an in-depth analysis of Johannes Nomsz’s play Iemant en Niemant (1768), this article explores how the seemingly anachronistic genre of zinnespel (morality play) could serve to negotiate key issues of eighteenth-century aesthetical discourse. The combination of abstract ideas and sensual images ingrained into this genre made it an ideal vehicle with which to approach one of the primary problems of the period, namely the mediation between reason and the senses. Nomsz’s play deals with this rationalist/empiricist divide concerning the moral philosophical question of whether reason or feelings guide human ethical behaviour. Through empathy with the allegorical character of Nobody, Nomsz draws his audience into the teeth of a moral dilemma through emotion rather than teaching them a moral lesson. At the same time, he connects moral sentiments to a rational procedure of moral self-judgement by staging conscience as an inner court. I call this way of applying the late medieval genre of morality play to the key questions of eighteenth-century aesthetics and philosophy ‘Enlightened zinnespel’. Turning to the zinnespel with its special capacity to merge mind and senses indicates that at this time, the role of art changed. Art was no longer seen as a medium of knowledge transference, but as a medium that could generate knowledge in a unique way because of its ability to combine cognitive, affective, and sensual dimensions.

Is severe alcohol use disorder really associated with increased utilitarian moral judgment? Exploration using the CNI model

ObjectivesThe psychology of moral decision-making classically contrasts utilitarianism (based on consequences) and deontology (based on moral norms). Previous studies capitalizing on this dichotomy have suggested the presence of a utilitarian bias among patients with severe alcohol use disorder (SAUD). We aimed to further disentangle the processes involved in such bias through a more validated approach, the CNI model of moral decision-making. This model allows to go further than the classical approach by distinguishing sensitivity to consequences (C), to moral norms (N), and general preference for inaction over action (I) in response to moral dilemmas. MethodsThirty-four recently detoxified patients with SAUD and 34 matched control participants completed a battery of 48 dilemmas derived from the CNI model, as well as social cognition tasks. ResultsIn contrast with the utilitarian bias suggested in previous studies based on the classical approach, patients with SAUD did not show an increased sensitivity to consequences in comparison with control participants. However, they showed a reduced sensitivity to moral norms, as well as a greater action tendency. These biases were not related to social cognition deficits. ConclusionsPatients with SAUD are not more utilitarian than healthy controls, this previously reported bias being artificially generated by the methodological limits of the classical approach. Instead, they present a reduced sensitivity to moral norms and an action bias, which might impact their interpersonal relations and contribute to the social isolation frequently reported in this population, thus identifying moral decision-making as a new therapeutic lever in SAUD.

A kényszergyógykezelés végrehajtása

The author provides on overview of the practical and moral dilemmas surrounding treatment in the Forensic Mental Institutions in Hungary.

Social decision making in binge drinking: An exploration through moral dilemmas.

The continuum hypothesis proposes that binge drinking and severe alcohol use disorder (SAUD) share qualitatively similar cognitive and emotional impairments. In SAUD, these deficits have a demonstrated impact on social decision making, resulting in a utilitarian bias. Namely, when confronted with moral dilemmas, patients with SAUD tend to focus on the consequences of their actions rather than on social norms. However, social decision-making abilities remain unexplored in binge drinking. We offered the first insights on the generalization of the continuum hypothesis to social decision making, through a multinomial processing tree model applied to moral dilemmas, the "CNI model" of moral decision making. We compared 35 binge drinkers (20 females) and 36 light drinkers (21 females) on a battery of 48 moral dilemmas involving interpersonal relations from the CNI model, through multinomial modeling analyses. In each dilemma, participants were asked if they would perform the described action, generating individual scores for sensitivity to consequences, sensitivity to norms, and inaction tendency. The statistical model related to the CNI approach fits the data well. Binge drinkers and controls did not differ regarding their sensitivity to consequences nor their sensitivity to moral norms, and both groups displayed an equal inaction tendency in response to moral dilemmas. We provided insights to better understand the specific (socio)cognitive domains impaired in subclinical populations with alcohol use disorder. We showed preserved social decision making in binge drinking, which suggests that the continuum hypothesis documented for classical neurocognitive functions does not extend to complex social abilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Analisis Framing Film Tuhan Izinkan Aku Berdosa

The film "Tuhan Izinkan Aku Berdosa" is an interesting work to be analyzed from the perspective of moral and religious framing. Hanung Bramantyo's film adaptation of Muhidin M. Dahlan's novel "Tuhan Izinkan Aku Menjadi Pelacur" offers a complex and controversial framing analysis. In this movie, themes of morality and religion are explored through a complex narrative and deep characters. The moral framing in the movie highlights the complex moral dilemma faced by the main character, who tries to balance between his religious faith and a complicated personal life. Religious framing in this context addresses the way the movie portrays religious teachings, religious practices, and their influence on the character's life. This research uses a descriptive qualitative method. George Lakoff's framing theory and framing theory in media studies provide a foundation for understanding how the selection of visual and narrative viewpoints can influence audience interpretation. The research is based on an in-depth literature study, including analysis of several related journals and books that discuss the role of framing in film. Through this approach, the movie "God Permits Me to Sin" is explained not only as a visual narrative, but also as a work of art that uses framing techniques to explore the psychological and social complexities in the story. .

AI art education - artificial or intelligent? Transformative pedagogic reflections from three art educators in Singapore

ABSTRACT With growing interest in the role and integration of Artificial Intelligence (AI) and AI pedagogies in transformative art education this paper voices the pedagogic reflections of three art educators in Singapore who have engaged AI in their art provision. It discusses and exemplifies the advantages (intelligent), like interdisciplinary opportunity, enhanced student engagement and increased connectionism, and limitations (artificial), like ethical and moral dilemmas and positioning, of AI integration in three art education settings showcasing how educators and learners engage. Model of pedagogic reflection is used to reveal how the educators provided transformative learning with AI, whilst showing the influence of personal art interests, technique modelling and professional reflections on teaching and making involving AI. Paper contributions include insights into and examples of AI practices and pedagogies (like AI literacy and prompt engineering), that are and could be used in art education, reflections on their successes and limits and commentary on the position of AI integration in the circular economy of art education. The paper is positioned to mobilize educator and student voice as an influential driver in the transformation of art education given ongoing developments in digital education futures.

Choosing between bad and worse: investigating choice in moral dilemmas through the lens of control.

People's preferences for the utilitarian outcome in sacrificial moral dilemmas, where a larger group of individuals are saved at the cost of a few, have been argued to be influenced by various factors. Taking expected utility (EU) theory into consideration, we investigate whether the expected effectiveness of actions elucidate certain inconsistencies in moral judgments. Additionally, we also explore whether participants' role in the dilemma as the executor or a superior who merely makes a decision, which is carried out by a subordinate, influences judgments-a factor generally overlooked by classical EU models. We test these hypotheses using a modified moral dilemma paradigm with a choice between two actions, one highly successful and the other more likely to fail. Both actions are either expected to result in a favorable outcome of saving five individuals by sacrificing one or an unfavorable outcome of sacrificing five to save one. When the efficient action is anticipated to lead to a favorable outcome, in line with EU models, people almost invariably choose the efficient action. However, in conditions where the EUs associated with efficient and inefficient actions are close to each other, people's choice for favored outcome is above chance when they act as agents themselves. We discuss the implications of our results for existing theories of moral judgments.

Censorship: A Moral Dilemma or an Immoral Siege on Freedom of Speech?

Censorship: A Moral Dilemma or an Immoral Siege on Freedom of Speech?

Alzheimer’s disease: A CRISPR/CAS9-mediated therapeutic approach

The degenerative nature of Alzheimer's disease (AD) and its severe effects on cognitive function present a major challenge to worldwide healthcare systems. CRISPR/Cas9, one of the most recent developments in gene-editing technology, has created new opportunities to investigate possible AD treatment approaches. The present state of AD research is reviewed in this paper, along with the possibility of using CRISPR/Cas9-mediated methods to target important genetic elements involved in AD pathogenesis. Through targeted gene editing linked to tau protein malfunction, neuroinflammation, and amyloid-beta accumulation, CRISPR/Cas9 presents a viable approach to altering the molecular course of disease. Additionally, using CRISPR/Cas9 in patient-specific induced pluripotent stem cells (iPSCs) may lead to personalized medicine strategies for the treatment of AD. Issues like delivery strategies, off-target impacts, and moral dilemmas are also covered. All things considered, the application of CRISPR/Cas9 technology to AD research is a fresh and potentially revolutionary strategy for creating targeted treatments for this intricate neurodegenerative illness. For the purpose of treating AD, more preclinical and clinical research is necessary to confirm the security and effectiveness of CRISPR/Cas9-based therapies. With the use of the CRISPR/Cas9 system, precise and effective genome modification is possible, enabling targeted editing of particular genes linked to the pathophysiology of AD. Thanks to this technology, genetic mutations in the presenilin 1 (PSEN1), presenilin 2 (PSEN2), and amyloid precursor protein (APP) genes that are linked to family types of AD can be corrected. It is feasible to restore normal protein function and possibly lessen the pathogenic processes that underlie AD by fixing these mutations.

When Your Friend is My Friend: How Loyalty Prompts Support for Indirect Ties in Moral Dilemmas

When Your Friend is My Friend: How Loyalty Prompts Support for Indirect Ties in Moral Dilemmas

PERSON’S CHOICE IN MORAL DILEMMAS SOLUTION SOCIONIC TYPE INFLUENCE

Background. The question of personality traits influence on a person's choice in solving moral issues is quite relevant and is widely represented in modern research in the personality psychology field. No one has conducted such studies using the socionic model yet. Purpose. The purpose of empirical study is to test the socionic type influence on person’s choice in moral dilemmas solving. Methodology. To conduct the research, we used methods of socionic type identification, author’s moral dilemmas solving test, factor and correlation analysis. Results. Provided factor analysis separated all questions from author’s tests into 5 factors, which we interpret like: personal safety, personal values, following public morality regulations, following the rules and laws, safety of loved ones. Correlation analysis for the factors and socionic traits revealed a positive correlation between the factor “personal safety” and the pole “Farsighted”. “Personal values” factor showed a positive correlation with the pole “Asking” and the factor “following the rules and laws” – with the pole “Result”. The factor “following public morality regulations” revealed a positive correlation with the poles “Dynamics” and “Serious”, and the factor “safety of loved ones” showed a positive correlation with the poles “Yielding”, “Tactical” and “Emotivist”. Practical implications. The findings contribute in definition of socionic traits clarification, to better understand their influence on observable human’s behavior. This ensures that practitioners who use socionic methods draw on the experimentally verified hypotheses.

Temporal Framework and Biological Indicators of Non-Suicidal Self-Injury and Related Behaviours.

Adolescence is a transitional stage between puberty and maturity. Significant alterations in brain chemistry and hormone activity cause mood swings and other psychological and physical symptoms. On their journey to adolescence, adolescents deal with complex emotions, moral dilemmas, sexual concerns, identity crises and particular societal expectations related to their upbringing. Impulsivity in adolescents is frequent and causes multiple issues. Impulsivity often lead towards non-suicidal self-injury (NSSI), which has devastating consequences, which are both physical and mental. Both impulsivity and NSSI have their roots in brain chemistry and its related functions. The aim of this special communication was to delve into brain chemistry through studying the function of neurotransmitters and brain areas in NSSI and impulsivity. Multiple papers were sought on the topic of neurochemistry and neuroanatomy. The results identified serotonin, dopamine and glutamate as the neurotransmitters responsible for NSSI and impulsivity. Dysregulation in these neurotransmitters lead to the presentation of NSSI and impulsivity. Other than the neurotransmitters, the brain areas identified were prefrontal cortex, medial prefrontal cortex and ventrolateral prefrontal cortex. The compiled results of this research would help individuals in understanding the neurotransmitters and the brain areas responsible. This would also help in generating awareness regarding the biological nature of the phenomenon as well, leading to less stigmatisation. The less stigmatisation towards these phenomena can help the affected individuals to seek help without any guilt or shame, along with support from society as well.

Moral dilemmas and limitations in global health practice

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Egy botrányos példázat – a szőlőmunkások (Mt 20,1-16)

We always take risk when we analyse biblical texts in order to reach its original setting and message. But this endevoir can be fruitful, as the problems surrounding the tenant worker’s parable clearly demonstrates. The interpretations of the church – throughout her whole history – unfortunatelly covered the scandal in this piece of artwork, and the problem of unjust payment has been explained as „radical grace”, as the result of the first worker’s laziness, bad attitude or the diligence of the latecomers. These misinterpretations do not make justice to the text. No explanation can cast shadow on the visible moral dilemma. The grapeyard owner throught Mediterranian eyes does not deserve sympathy, his deed cannot be excused. We got used to look at this story from the viewpoint of the last hired laborers. We are thankful for such a grace – but the parable forces us to the role of the first workers, who legitimately protest against the disproportionate wage. Only through our indignation, dispise, annoyment can we arrive to the real understanding, accepting that we would never act like the owner, that according to our measures and ideals this act is a scandal. Only after this confession can we arrive to the last workers – and to the undeserved and disturbing grace.

Taking a moral holiday? Physicians’ practical identities at the margins of professional ethics

Physicians frequently encounter situations in which their professional practice is intermingled with moral affordances stemming from other domains of the physician’s lifeworld, such as family and friends, or from general...

Regional differences in public perceptions of autonomous vehicles facing moral dilemmas: a comparative study between the United States, Hong Kong, and China

Regional differences in public perceptions of autonomous vehicles facing moral dilemmas: a comparative study between the United States, Hong Kong, and China

The relationship between moral reasoning and nurses’ professional values in undergraduate nursing students: a descriptive-correlational study

BackgroundMoral reasoning in nursing is crucial in delivering high-quality patient care and fostering increased job satisfaction among nurses. Adhering to professional values is vital to this profession, and nurses must modify their actions to align with these values.ObjectiveThis study aimed to examine the correlation between moral reasoning and professional values among undergraduate nursing students.Research designA descriptive correlational design was recruited.Participants and research contextThe research was conducted at three nursing schools located in Tehran, Iran. The sample was recruited through random stratified sampling, specifically targeting undergraduate nursing students. The data collection tool comprised a three-part questionnaire, including a demographic information form, the Nursing Dilemma Test, and the Nurses Professional Values Scale Revised Questionnaire. The distribution of questionnaires encompassed both face-to-face and electronic methods. The analysis of data was conducted using SPSS 16 software. The data was analyzed using the independent samples t-test, Pearson’s correlation coefficient, and linear regression analysis. The P value of 0.05 was considered significant.Ethical considerationsThe Ethics Research Center of Shahid Beheshti University of Medical Sciences approved the study.FindingsData analysis showed that moral reasoning was directly correlated to professional values (r = 0.528, p < 0.001). The mean scores of Principled Thinking (P.T.), Practical Consideration (P.C.), and Familiarity with similar moral dilemmas of the NDT scale were 42.55 (SD = 12.95), 15.72 (SD = 6.85), 16.08 (SD = 6.67), respectively. Also, the total score of professional values of students was 90.63 (SD = 28.80).ConclusionThe findings indicated that moral reasoning and interest in nursing predict students’ professional identity. Thus, any effort to enhance interest in the profession can contribute to developing students’ professional identity. This can involve incentivizing, enhancing the professional reputation at the community and university levels, and valuing student preferences and necessities.

Complexities in supportive care for people with metastatic breast cancer: a qualitative study.

The complexity of metastatic breast cancer, its rapidly evolving treatment, and the changing trajectory toward long-term survivorship create unique challenges for the provision of supportive care. The experiences of health professionals enacting supportive care in contexts of those living long-term with incurable cancer have received limited research attention. This qualitative study aimed to gain further insight into health professionals' experiences of supportive care in this context. Semi-structured interviews were conducted via phone and online with 25 health and community-care professionals who support people living with metastatic breast cancer in Australia. A mix of sampling strategies was used. Thematic analysis was undertaken. Findings were interpreted through an ethics of care lens. Three key themes were identified. First, participants experienced supportive care as highly relational. Second, they encountered numerous moral and ethical dilemmas in enacting supportive care. Finally, enacting supportive care was complicated by fragmented and sporadic provision in a system in which supportive care is differentially valued across professions and settings. Findings draw attention to complexities in enacting supportive care in the context of metastatic breast cancer, with implications to patients and professionals. To improve the quality of care provided to patients and minimise the risk of professional burnout, greater attention is needed in supportive care guidelines to the ethical, moral, and emotional complexities experienced by professionals in this context. People living with metastatic breast cancer are a growing proportion of cancer survivors. The knowledge gained through this study may help professionals to better meet the supportive care needs of people living with metastatic breast cancer, a treatable but not curable condition.