Subtracting insult from injury: addressing cultural expectations in the disclosure of medical error.
(9/41)
This article proposes that knowledge of cultural expectations concerning ethical responses to unintentional harm can help students and physicians better to understand patients' distress when physicians fail to disclose, apologize for, and make amends for harmful medical errors. While not universal, the Judeo-Christian traditions of confession, repentance, and forgiveness inform the cultural expectations of many individuals within secular western societies. Physicians' professional obligations concerning truth telling reflect these expectations and are inclusive of the disclosure of medical error, while physicians may express a need for self-forgiveness after making errors and should be aware that patients may also rely upon forgiveness as a means of dealing with harm. The article recommends that learning how to disclose errors, apologize to injured patients, ensure that these patients' needs are met, and confront the emotional dimensions of one's own mistakes should be part of medical education and reinforced by the conduct of senior physicians. (+info)
Practical virtue ethics: healthcare whistleblowing and portable digital technology.
(10/41)
Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers' agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical "coalfaces". Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety.Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development. (+info)
On the definition of the concepts thinking, consciousness, and conscience.
(11/41)
A complex system (CS) is defined as a set of elements, with connections between them, singled out of the environment, capable of getting information from the environment, capable of making decisions (i.e., of choosing between alternatives), and having purposefulness (i.e., an urge towards preferable states or other goals). Thinking is a process that takes place (or which can take place) in some of the CS and consists of (i) receiving information from the environment (and from itself), (ii) memorizing the information, (iii) the subconscious, and (iv) consciousness. Life is a process that takes place in some CS and consists of functions i and ii, as well as (v) reproduction with passing of hereditary information to progeny, and (vi) oriented energy and matter exchange with the environment sufficient for the maintenance of all life processes. Memory is a complex of processes of placing information in memory banks, keeping it there, and producing it according to prescriptions available in the system or to inquiries arising in it. Consciousness is a process of realization by the thinking CS of some set of algorithms consisting of the comparison of its knowledge, intentions, decisions, and actions with reality--i.e., with accumulated and continuously received internal and external information. Conscience is a realization of an algorithm of good and evil pattern recognition. (+info)
Moral emotions and moral behavior.
(12/41)
Moral emotions represent a key element of our human moral apparatus, influencing the link between moral standards and moral behavior. This chapter reviews current theory and research on moral emotions. We first focus on a triad of negatively valenced "self-conscious" emotions-shame, guilt, and embarrassment. As in previous decades, much research remains focused on shame and guilt. We review current thinking on the distinction between shame and guilt, and the relative advantages and disadvantages of these two moral emotions. Several new areas of research are highlighted: research on the domain-specific phenomenon of body shame, styles of coping with shame, psychobiological aspects of shame, the link between childhood abuse and later proneness to shame, and the phenomena of vicarious or "collective" experiences of shame and guilt. In recent years, the concept of moral emotions has been expanded to include several positive emotions-elevation, gratitude, and the sometimes morally relevant experience of pride. Finally, we discuss briefly a morally relevant emotional process-other-oriented empathy. (+info)
ADH7 variation modulates extraversion and conscientiousness in substance-dependent subjects.
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Human personality traits have been closely linked to substance dependence (SD), and are partially genetically determined. Recently, associations between alcohol dehydrogenase 7 (ADH7) and SD have been reported, which led us to investigate the relationship between ADH7 variation and personality traits. We assessed dimensions of the five-factor model of personality and genotyped 4 ADH7 markers and 38 unlinked ancestry-informative markers in 244 subjects with SD [178 European-Americans (EAs) and 66 African-Americans (AAs)] and 293 healthy subjects (253 EAs and 40 AAs). The relationships between ADH7 markers and personality traits were comprehensively examined using multivariate analysis of covariance (MANCOVA), and then decomposed by Roy Bargmann Stepdown analysis of covariance (ANCOVA). Generally, older individuals, AAs, and males had significantly lower personality scores (4.7 x 10(-5) < or = P < or = 0.032), as reported previously. In SD subjects, Extraversion was most significantly associated with ADH7 haplotypes (3.7 x 10(-4) < or = P < or = 0.001), diplotypes (0.007 < or = P < or = 0.012), and genotypes (P = 0.001), followed by Conscientiousness (0.005 < or = P < or = 0.033). The contributory haplotype and diplotypes contained the alleles and genotypes of rs284786 (SNP1) and rs1154470 (SNP4). In healthy subjects, other personality factors (except Extraversion) were associated with ADH7 diplotypes (0.005 < or = P < or = 0.016) and genotypes (0.002 < or = P < or = 0.052). Some of the gene effects on personality factors were modified by sex. The present study demonstrated that the ADH7 variation may contribute to the genetic component of variation in personality traits, with the risk for SD and personality traits being partially shared. (+info)
Coparenting and early conscience development in the family.
(14/41)
In the current research, the authors examined children's observed compliance in a family clean-up paradigm and parents' reports of coparenting to predict young children's conscience (e.g., affective discomfort and moral regulation) in a sample of 58 families with two parents and at least two children. The authors found relations between parents' reports of children's conscience development and observer-rated compliance in a family clean-up session, and significant correlations between coparenting and conscience development. There were a greater number of significant results for younger, 2-year-old siblings than for older siblings, which may reflect the importance of the period between 2 and 3 years for the emergence of conscience. Multiple regressions revealed that younger siblings' age, observed compliance/noncompliance, and parents' reports of coparenting were all significant in predicting parents' reports of affective discomfort and moral regulation. Findings underscore the importance of continuing research on whole-family dynamics when studying young children's early conscience and moral regulation. (+info)
Personality factors and profiles in variants of irritable bowel syndrome.
(15/41)
AIM: To study the association between irritable bowel syndrome (IBS) variants (constipation, diarrhea, or both) and personality traits in non-psychiatric patients. METHODS: IBS was diagnosed using the Rome II diagnostic criteria after exclusion of organic bowel pathology. The entry of each patient was confirmed following a psychiatric interview. Personality traits and the score of each factor were evaluated using the NEO Five Factor Inventory. RESULTS: One hundred and fifty patients were studied. The mean age (+/- SD) was 33.4 (+/- 11.0) year (62% female). Subjects scored higher in neuroticism (26.25 +/- 7.80 vs 22.92 +/- 9.54, P < 0.0005), openness (26.25 +/- 5.22 vs 27.94 +/- 4.87, P < 0.0005) and conscientiousness (32.90 +/- 7.80 vs 31.62 +/- 5.64, P < 0.01) compared to our general population derived from universities of Iran. Our studied population consisted of 71 patients with Diarrhea dominant-IBS, 33 with Constipation dominant-IBS and 46 with Altering type-IBS. Scores of conscientiousness and neuroticism were significantly higher in C-IBS compared to D-IBS and A-IBS (35.79 +/- 5.65 vs 31.95 +/- 6.80, P = 0.035 and 31.97 +/- 9.87, P = 0.043, respectively). Conscientiousness was the highest dimension of personality in each of the variants. Patients with C-IBS had almost similar personality profiles, composed of higher scores for neuroticism and conscientiousness, with low levels of agreeableness, openness and extraversion that were close to those of the general population. CONCLUSION: Differences were observed between IBS patients and the general population, as well as between IBS subtypes, in terms of personality factors. Patients with constipation-predominant IBS showed similar personality profiles. Patients with each subtype of IBS may benefit from psychological interventions, which can be focused considering the characteristics of each subtype. (+info)
The truth about lying: inhibition of the anterior prefrontal cortex improves deceptive behavior.
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