Healthcare workers experience moral injury (MI), a violation of their moral code due to circumstances beyond their control. MI threatens the healthcare workforce in all settings and leads to medical errors, depression/anxiety, and personal and occupational dysfunction, significantly affecting job satisfaction and retention. This article aims to differentiate concepts and define causes surrounding MI in healthcare. A narrative literature review was performed using SCOPUS, CINAHL, and PubMed for peer-reviewed journal articles published in English between 2017 and 2023. Search terms included (...) “moral injury” and “moral distress,” identifying 249 records. While individual risk factors predispose healthcare workers to MI, root causes stem from healthcare systems. Accumulation of moral stressors and potentially morally injurious events (PMIEs) (from administrative burden, institutional betrayal, lack of autonomy, corporatization of healthcare, and inadequate resources) result in MI. Individuals with MI develop moral resilience or residue, leading to burnout, job abandonment, and post-traumatic stress. Healthcare institutions should focus on administrative and climate interventions to prevent and address MI. Management should ensure autonomy, provide tangible support, reduce administrative burden, advocate for diversity of clinical healthcare roles in positions of interdisciplinary leadership, and communicate effectively. Strategies also exist for individuals to increase moral resilience, reducing the impact of moral stressors and PMIEs. (shrink)

Thus far, we know much more about the significant outcomes of perceived ethical leadership than we do about its antecedents. In this study, we focus on multiple types of ethical role models as antecedents of perceived ethical leadership. According to social learning theory, role models facilitate the acquisition of moral and other types of behavior. Yet, we do not know whether having had ethical role models influences follower perceptions of one’s ethical leadership and, if so, what kinds of role models (...) are important. We conducted a field study, surveying supervisors and their subordinates to examine the relationship between three types of ethical role models and ethical leadership: the leader’s childhood role models, career mentors, and top managers. We found that having had an ethical role model during the leader’s career was positively related to subordinate-rated ethical leadership. As expected, this effect was moderated by leader age, such that the relationship between career mentoring and ethical leadership was stronger for older leaders. Leader age also moderated the relationship between childhood models and ethical leadership ratings, such that having had childhood ethical role models was more strongly and positively related to ethical leadership for younger leaders. We found no effect for top management ethical role models. Implications for research and practice are discussed. (shrink)

Young adults' attitudes toward the use of animals in scientific research were examined by using data from the Longitudinal Study of American Youth . A structural equation model was estimated using LISREL8 to examine the development of these attitudes. Gender was found to have the greatest total effect on opposition to animal research, while feminist attitudes had the second greatest total effect. Feminist attitudes, 10th grade science achievement, adult scientific literacy, general attitudes toward science, partisan affiliation, anda numberof early home (...) influences each explained part, but not all of the gender difference in attitudes about scientific research. (shrink)

This essential that prospective teachers develop critical thinking skills. However, they cannot develop these skills simply by reading the assigned text, taking notes during lecture, and completing exams. The case method of instruction (CMI) relies on real-life situations to teach students general problem solving and decision making through active participation in the leaming process. Thus, CMI offers an effective means of developing the critical thinking skills of prospective teachers. This article presents guidelines teacher educators can follow to create case-based classrooms. (...) Specific recommendations are offered regarding case selection, case presentation, case writing, and case evaluation procedures. (shrink)

Recent allegations of unethical decision-making by leaders in prominent business organizations have jeopardized the world's confidence in American business. The purpose of this research was to develop a measure of managerial moral judgment that can be used in future research and managerial assessment. The measure was patterned after the Defining Issues Test, a widely used general measure of moral judgment. With content validity as the goal, we aimed to sample the domain of managerial ethical situations by establishing links to dimensions (...) of managerial performance, as well as to the types of organizational justice issues managers encounter. Proposed scenarios were evaluated for realism by ethics officers and human resource managers. Results indicated that the new measure is reliable and correlates with a number of relevant variables in the hypothesized manner, demonstrating evidence of construct validity. Implications for future research and for human resources management are discussed. (shrink)

ABSTRACT:In the expanding field of ethical leadership research, little attention has been paid to the association between ethical leaders’ ethical characteristics and perceived ethical leadership, and, more importantly, the potential influence of ethical leadership on followers’ ethical characteristics. In this study, we tested a theoretical model based upon social cognitive theory to examine leaders’ moral identity and moral attentiveness as antecedents of perceived ethical leadership, and follower moral identity and moral attentiveness as outcomes of ethical leadership. Based upon data from (...) 89 leaders and 460 followers in China, collected at two points in time, we found that leaders’ moral identity and moral attentiveness are associated with follower’s perceptions of ethical leadership. Ethical leadership is, in turn, associated with their followers’ moral identity and moral attentiveness. We found furthermore that ethical leadership mediates the effect of leaders’ moral identity on followers’ moral identity, but not the effect of leaders’ moral attentiveness on followers’ moral attentiveness. We discuss the findings, theoretical contributions, practical implications, and future research. (shrink)

Business Ethics: A European Review, EarlyView.

The Politics of the Texbook analyzes the factors that shape production, distribution and reception of school texts through original essays which emphasize the double-edged quality of textbooks. Textbooks are viewed as systems of moral regulation in the struggle of powerful groups to build political and cultural accord. They are also regarded as the site of popular resistance around discloding the interest underlying schoolknowledge and incorporating alternative traditions.

In this study, we test the interactive effect on ethical decision-making of (1) personal characteristics, and (2) personal expectanciesbased on perceptions of organizational rewards and punishments. Personal characteristics studied were cognitive moral developmentand belief in a just world. Using an in-basket simulation, we found that exposure to reward system information influenced managers’ outcome expectancies. Further, outcome expectancies and belief in a just world interacted with managers’ cognitive moral development to influence managers’ ethical decision-making. In particular, low-cognitive moral development managers who (...) expected that their organization condoned unethical behavior made less ethical decisions while high cognitive moral development managers became more ethical in this environment. Low cognitive moral development managers also behaved less ethically when their belief in a just world was high. (shrink)

In this study, we test the interactive effect on ethical decision-making of (1) personal characteristics, and (2) personal expectanciesbased on perceptions of organizational rewards and punishments. Personal characteristics studied were cognitive moral developmentand belief in a just world. Using an in-basket simulation, we found that exposure to reward system information influenced managers’ outcome expectancies. Further, outcome expectancies and belief in a just world interacted with managers’ cognitive moral development to influence managers’ ethical decision-making. In particular, low-cognitive moral development managers who (...) expected that their organization condoned unethical behavior made less ethical decisions while high cognitive moral development managers became more ethical in this environment. Low cognitive moral development managers also behaved less ethically when their belief in a just world was high. (shrink)

Recent allegations of unethical decision-making by leaders in prominent business organizations have jeopardized the world’s confidence in American business. The purpose of this research was to develop a measure of managerial moral judgment that can be used in future research and managerial assessment. The measure was patterned after the Defining Issues Test, a widely used general measure of moral judgment. With content validity as the goal, we aimed to sample the domain of managerial ethical situations by establishing links to dimensions (...) of managerial performance, as well as to the types of organizational justice issues managers encounter. Proposed scenarios were evaluated for realism by ethics officers and human resource managers. Results indicated that the new measure is reliable and correlates with a number of relevant variables in the hypothesized manner, demonstrating evidence of construct validity. Implications for future research and for human resources management are discussed. (shrink)

Organizations differ in the extent to which they emphasize the importance of status, yet most extant research on the role of status at work has utilized a limited view of status as merely a matter of a person’s status rank. In contrast, we examine people’s perceptions of the extent to which having status matters in their work context and explore the behavioral implications of such perceptions. We offer a new construct, perceived status importance, defined as employees’ subjective assessment of the (...) degree to which people within their organization are preoccupied with status. Relying on social comparison theory, we propose that higher perceived status importance triggers envy, which leads to interpersonal deviance. Across three studies, using multiwave survey and experimental designs, we find support for these relationships. We also find support for the mitigating influence of core self-evaluations on the perceived status importance—envy relationship. Implications are discussed. (shrink)

Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

The popular view of non-directive genetic counseling limits the counselor's role to providing information to clients and assisting families in making decisions in a morally neutral fashion. This view of non-directive genetic counseling is shown to be incomplete. A fuller understanding of what it means to respect autonomy shows that merely respecting client choices does not exhaust the duty. Moreover, the genetic counselor/client relationship should also be governed by the counselor's commitment to the principle of beneficience. When non-directive counseling is (...) reexamined in light of both these principles, it becomes clear that there are cases in which counselors should attempt to persuade clients to reconsider their decisions. Such attempts are consistent with non-directive counseling because, while respecting the clients' decision-making authority, they insure that clients act with full knowledge of the moral consequences of their decisions. (shrink)

A paper was published in 2003 discussing the ethics of nurses participating in executions by inserting the intravenous line for lethal injections and providing care until death. This paper was circulated on an international email list of senior nurses and academics to engender discussion. From that discussion, several people agreed to contribute to a paper expressing their own thoughts and feelings about the ethics of nurses participating in executions in countries where capital punishment is legal. While a range of opinions (...) were presented, these opinions fell into two main themes. The first of these included reflections on the philosophical obligations of nurses as caregivers who support those in times of great need, including condemned prisoners at the end of life. The second theme encompassed the notion that no nurse ever should participate in the active taking of life, in line with the codes of ethics of various nursing organisations. This range of opinions suggests the complexity of this issue and the need for further public discussion. (shrink)

For action systems, the critical task is to predict what will happen next. In language, however, the critical task is not to predict the next auditory event but to extract meaning. Reducing language to an action system, and putting prediction at center, mistakenly marginalizes our core capacity to communicate the novel and unpredictable.

We have been teaching gender issues and feminist theory for many years, and we know that there is certainly a diversity of views among women, and men, about what counts as feminist or as good for women. Some may see a competent woman running for V.P as inevitably a step forward for women's equality. But consider this.

Introduction: Alcohol approach bias, the tendency to automatically move toward alcohol cues, has been observed in people who drink heavily. However, surprisingly, some alcohol-dependent patients demonstrate an alcohol avoidance bias. This inconsistency could be explained by the clinical or demographic profile of the population studied, yet this has not been examined in approach bias modification trials to date. We aimed to determine the proportion of patients with an approach or avoidance bias, assess whether they differ on demographic and drinking measures, (...) and to examine the clinical correlates of approach bias.Method: These research questions were addressed using baseline data from 268 alcohol-dependent patients undergoing inpatient withdrawal treatment who then went on to participate in a trial of ABM.Results: At trial entry, 155 had an alcohol approach bias and 113 had an avoidance bias. These two groups did not differ on any demographic or relevant drinking measures. Approach bias was significantly and moderately associated with total standard drinks consumed in the past 30 days but no other indices of alcohol consumption or problem severity.Conclusion: Whilst the majority of alcohol-dependent patients showed an alcohol approach bias, those with an avoidance bias did not differ in demographic or clinical characteristics, and the strength of approach bias related only to recent consumption. Further research is needed to develop more accurate and personally tailored measures of approach bias, as these findings likely reflect the poor reliability of standard approach bias measures. (shrink)

Various authors, for instance Elizabeth Anderson, Rosemary Tong, Mary Warnock and Margaret Brazier have argued that commercial surrogate motherhood is exploitative and that it should be prohibited. Their arguments are unconvincing. Exploitation is a more complex notion than it is usually presented as being. Unequal bargaining power can be a cause of exploitation but the exercise of unequal bargaining power is not inevitably or inherently exploitative. Exploitation concerns unfair and/or unjust strategies - rather than the exercise of power as such. (...) Commercial surrogate motherhood is not necessarily exploitative. Furthermore, not all transactions which are exploitative should be made illegal. (shrink)

Le Grand describes a situation where a drunk driver, who has medical insurance, is the cause of an accident in which he and a sober pedestrian, who has no medical insurance, are both equally and seriously injured. At the private hospital to which they are both taken, there is available emergency treatment for one of them only. Who should receive it? The issues raised by Le Grand's example are shown to be more interesting, more complex and less clearcut than Le (...) Grand suggests and implies. In particular, it is not the case that, unequivocally, the drunkenness of the driver establishes that the pedestrian rather than he should be treated nor that, unequivocally, the driver's possession of health insurance is morally irrelevant. (shrink)

The gelsolin gene family encodes a number of higher eukaryotic actin-binding proteins that are thought to function in the cytoplasm by severing, capping, nucleating or bundling actin filaments. Recent evidence, however, suggests that several members of the gelsolin family may have adopted unexpected nuclear functions including a role in regulating transcription. In particular, flightless I, supervillin and gelsolin itself have roles as coactivators for nuclear receptors, despite the fact that their divergence appears to predate the evolutionary appearance of nuclear receptors. (...) Flightless I has been shown to bind both actin and the actin-related BAF53a protein, which are subunits of SWI/SNF-like chromatin remodelling complexes. The primary sequences of some actin-related proteins such as BAF53a exhibit conservation of residues that, in actin itself, are known to interact with gelsolin-related proteins. In summary, there is a growing body of evidence supporting a biological role in the nucleus for actin, Arps and actin-binding proteins and, in particular, the gelsolin family of actin-binding proteins. (c) 2005 Wiley Periodicals, Inc. (shrink)

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be (...) instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

Compared to other health care professions such as medicine, nursing and pharmacy, few studies have been conducted to examine the nature of practice errors in occupational and physical therapy. In an ongoing study to determine root causes, typographies and impact of occupational and physical therapy error on patients, focus group interviews have been conducted across the United States. A substantial number of harmful practice errors and/or other patient safety events (deviations or accidents) have been identified. Often these events have had (...) moral dimensions that troubled the therapist involved. In this article, six of these transcribed cases are analyzed, using predominant bioethical theories, ethical principles and professional codes of ethics. The cases and their analyses are intended to be exemplary, improving the readers’ ability to discern and critically address similar such events. Several patient safety strategies are suggested that might have prevented the events described in these cases. (shrink)