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Moral Dilemma (moral + dilemma)
Selected AbstractsMoral dilemmas and ethical controversies (Respond to this article at http://www.therai.org.uk/at/debate)ANTHROPOLOGY TODAY, Issue 1 2010Mako John Kuwimb No abstract is available for this article. [source] Moral dilemmas and ethical controversiesANTHROPOLOGY TODAY, Issue 6 2009Stuart Kirsch In his guest editorial, Stuart Kirsch revisits the controversy surrounding Jared Diamond's NEW YORKER essay on vengeance and the state, drawing attention to how anthropologists discuss the ethical responsibilities of ethnographers. [source] Diversity of effective treatments of panic attacks: what do they have in common?,DEPRESSION AND ANXIETY, Issue 1 2010Walton T. Roth M.D. Abstract By comparing efficacious psychological therapies of different kinds, inferences about common effective treatment mechanisms can be made. We selected six therapies for review on the basis of the diversity of their theoretical rationales and evidence for superior efficacy: psychoanalytic psychotherapy, hypercapnic breathing training, hypocapnic breathing training, reprocessing with and without eye-movement desensitization, muscle relaxation, and cognitive behavior therapy. The likely common element of all these therapies is that they reduce the immediate expectancy of a panic attack, disrupting the vicious circle of fearing fear. Modifying expectation is usually regarded as a placebo mechanism in psychotherapy, but may be a specific treatment mechanism for panic. The fact that this is seldom the rationale communicated to the patient creates a moral dilemma: Is it ethical for therapists to mislead patients to help them? Pragmatic justification of a successful practice is a way out of this dilemma. Therapies should be evaluated that deal with expectations directly by promoting positive thinking or by fostering non-expectancy. Depression and Anxiety, 2010. Published 2009 Wiley-Liss, Inc. [source] Rethinking Medical Ethics: A View From BelowDEVELOPING WORLD BIOETHICS, Issue 1 2004Paul Farmer ABSTRACT In this paper, we argue that lack of access to the fruits of modern medicine and the science that informs it is an important and neglected topic within bioethics and medical ethics. This is especially clear to those working in what are now termed ,resource-poor settings', to those working, in plain language, among populations living in dire poverty. We draw on our experience with infectious diseases in some of the poorest communities in the world to interrogate the central imperatives of bioethics and medical ethics. AIDS, tuberculosis, and malaria are the three leading infectious killers of adults in the world today. Because each disease is treatable with already available therapies, the lack of access to medical care is widely perceived in heavily disease-burdened areas as constituting an ethical and moral dilemma. In settings in which research on these diseases are conducted but there is little in the way of therapy, there is much talk of first world diagnostics and third world therapeutics. Here we call for the ,resocialising' of ethics. To resocialise medical ethics will involve using the socialising disciplines to contextualise fully ethical dilemmas in settings of poverty and, a related gambit, the systematic participation of the destitute sick. Clinical research across steep gradients also needs to be linked with the interventions that are demanded by the poor and otherwise marginalised. We conclude that medical ethics must grapple more persistently with the growing problem posed by the yawning ,outcome gap' between rich and poor. [source] Posterior cingulate activation during moral dilemma in adolescentsHUMAN BRAIN MAPPING, Issue 8 2008Jesus Pujol Abstract Neuroimaging research examining correlates of adolescent behavioral maturation has focused largely on issues related to higher cognitive development. Currently few studies have explored neural correlates of emotional reactivity in adolescent groups. In this study, we sought to examine the nature of posterior cingulate activation during situations of moral dilemma in normal adolescents. We focused on this region because of emerging evidence that suggests its role in emotionally self-relevant mental processing. Ten healthy teenagers, aged from 14 to 16 years, underwent three fMRI sequences designed to examine (i) brain responses during moral dilemma; (ii) brain responses during passive viewing of the moral dilemma outcome; and (iii); "deactivation" during a simple cognitive task compared with resting-state activity. Our main finding was that during moral dilemma, all subjects showed significant activation of the posterior cingulate cortex, and more variable activation of the medial frontal cortex and angular gyrus. Interestingly, these findings were replicated in each subject using the passive viewing task, suggesting that the previous pattern was not specific to moral reasoning or decision making. Finally, six of the ten subjects showed deactivation of the same posterior cingulate region during the cognitive task, indicating some commonality of function between posterior cingulate activity during moral dilemmas and rest. We propose that these posterior cingulate changes may relate to basic neuronal activities associated with processing self-relevant emotional stimuli. Given the high single-subject reproducibility of posterior cingulate activations, our findings may contribute to further characterize adolescent emotional reactivity in developmental neuroimaging studies. Hum Brain Mapp, 2008. © 2007 Wiley-Liss, Inc. [source] Moral Dilemmas Film Task: a study of spontaneous narratives by individuals with autism spectrum conditionsAUTISM RESEARCH, Issue 3 2009Jennifer L. Barnes Abstract People with autism spectrum conditions (ASC) have difficulties with mentalizing, empathy, and narrative comprehension. A new test of social and narrative cognition, the Moral Dilemmas Film Task, was developed to probe individuals' spontaneous understanding of naturalistic film scenes. Twenty-eight individuals with ASC and 28 neurotypical controls, matched for age, sex, and IQ, watched four short emotionally charged film clips each depicting a moral dilemma, and were asked to write about what they had seen. Individuals with ASC produced significantly shorter film-based narratives and showed a smaller bias for mental states over objects in their narratives than controls. A significant correlation was found between verbal IQ and the level of mentalizing in film narratives for the ASC group, but not the control group, while the reverse pattern was found with a measure of self-reported cognitive and affective empathy. These results suggest that to the extent that both groups succeed in viewing moral dilemmas in terms of mental content, they do so in different ways, with individuals with ASC using verbal scaffolding to increase their ability to draw meaning from social scenes. The well-established empathy deficit in ASC extends to spontaneous interpretation of moral dilemmas. This new film task has the potential to assay different aspects of how the social world is represented differently in ASC, including during moral comprehension. [source] Posterior cingulate activation during moral dilemma in adolescentsHUMAN BRAIN MAPPING, Issue 8 2008Jesus Pujol Abstract Neuroimaging research examining correlates of adolescent behavioral maturation has focused largely on issues related to higher cognitive development. Currently few studies have explored neural correlates of emotional reactivity in adolescent groups. In this study, we sought to examine the nature of posterior cingulate activation during situations of moral dilemma in normal adolescents. We focused on this region because of emerging evidence that suggests its role in emotionally self-relevant mental processing. Ten healthy teenagers, aged from 14 to 16 years, underwent three fMRI sequences designed to examine (i) brain responses during moral dilemma; (ii) brain responses during passive viewing of the moral dilemma outcome; and (iii); "deactivation" during a simple cognitive task compared with resting-state activity. Our main finding was that during moral dilemma, all subjects showed significant activation of the posterior cingulate cortex, and more variable activation of the medial frontal cortex and angular gyrus. Interestingly, these findings were replicated in each subject using the passive viewing task, suggesting that the previous pattern was not specific to moral reasoning or decision making. Finally, six of the ten subjects showed deactivation of the same posterior cingulate region during the cognitive task, indicating some commonality of function between posterior cingulate activity during moral dilemmas and rest. We propose that these posterior cingulate changes may relate to basic neuronal activities associated with processing self-relevant emotional stimuli. Given the high single-subject reproducibility of posterior cingulate activations, our findings may contribute to further characterize adolescent emotional reactivity in developmental neuroimaging studies. Hum Brain Mapp, 2008. © 2007 Wiley-Liss, Inc. [source] Arms Transfers beyond the State-to-State RealmINTERNATIONAL STUDIES PERSPECTIVES, Issue 2 2009Denise Garcia Arms transfers beyond the state-to-state realm can have harmful effects for international security dramatically affecting the relations and behavior of states. This article examines why an emerging international norm on "prohibiting states to transfer arms to nonstate groups" has failed to diffuse at the international level. It discusses the already available international law framework existing at the regional and international levels upon which the potential norm could be built. The failure of the norm to diffuse at the international level can be primarily explained by the existence of a long-consolidated norm: the customary practice of states to transfer weapons to nonstate actors, that is, groups they deem legitimate to, without any interference or constraint.1 The unrestrained transfer of weapons is an established foreign-policy practice. It is the way states form, uphold alliances, extend friendships, and build spheres of influence (Sorokin 1994). Clearly, no state willingly wants to give this up. Therefore, the multilateral agreement on a norm barring most or all transfers of weapons to nonstate actors would curtail the freedom of action to build spheres of influence as states please. There are genuine ethical and moral dilemmas in this discussion, a nonstate actor may be a freedom fighter or a terrorist depending on different perspectives. The distinction between the categories "state" and "nonstate" actors may risk classifying actors in two camps: the good and the bad, respectively. This is problematic as a few states are known to be the most brutal perpetrators of egregious violations against their own citizens, whereas certain nonstate actors are legitimately fighting for the protection of vulnerable populations. [source] An exploration of mental health nursing students' experiences and attitudes towards using cigarettes to change client's behaviourJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2010M. J. NASH msc pclt bsc (hons) rnt rmn fhea Accessible summary ,,This study explores the experiences of mental health nursing students in using cigarettes as a means of token economy. ,,The majority of the sample experienced the use of this particular intervention in various settings but also reported that other items apart from cigarettes were also used as part of a reward system. ,,Respondents generally did not like this practice, feeling that it did not work well, led to client staff conflict, was implemented in an ad hoc way and rarely recorded in a care plan. ,,An open debate on tobacco control and the use of cigarettes in behavioural change programmes is urgently required. Abstract Using cigarettes to change client behaviour is a common, yet little studied, practice in mental health care. A questionnaire survey was used to explore mental health nursing student's experiences and attitudes to this practice. The sample was four cohorts of mental health nursing students (n= 151). Of them, 84% had experienced the practice of using cigarettes to change client behaviour in acute wards (73%), rehabilitation wards (28%) and elderly care (14%). Cigarettes were used to change client behaviour in areas such as attending to personal hygiene (57%) or engaging in the ward routine (39%). However, items such as leave (60%) or drinks (tea and coffee) (38%) were also reportedly used. Of the respondents, 54% inferred that the practice did not work well with 46% stating it was not written up in care plans; 52% felt it was an ad hoc practice, 60% inferred that at times it was used as a punishment while 55% intimated that they felt bad withholding cigarettes. There are ethical and moral dilemmas around using lifestyle risk factors as rewards or using client's nicotine addiction as a means of controlling behaviour. The question of whether this intervention should ever be used, given its associated health risk, requires more critical debate in clinical practice. [source] Moral Dilemmas Film Task: a study of spontaneous narratives by individuals with autism spectrum conditionsAUTISM RESEARCH, Issue 3 2009Jennifer L. Barnes Abstract People with autism spectrum conditions (ASC) have difficulties with mentalizing, empathy, and narrative comprehension. A new test of social and narrative cognition, the Moral Dilemmas Film Task, was developed to probe individuals' spontaneous understanding of naturalistic film scenes. Twenty-eight individuals with ASC and 28 neurotypical controls, matched for age, sex, and IQ, watched four short emotionally charged film clips each depicting a moral dilemma, and were asked to write about what they had seen. Individuals with ASC produced significantly shorter film-based narratives and showed a smaller bias for mental states over objects in their narratives than controls. A significant correlation was found between verbal IQ and the level of mentalizing in film narratives for the ASC group, but not the control group, while the reverse pattern was found with a measure of self-reported cognitive and affective empathy. These results suggest that to the extent that both groups succeed in viewing moral dilemmas in terms of mental content, they do so in different ways, with individuals with ASC using verbal scaffolding to increase their ability to draw meaning from social scenes. The well-established empathy deficit in ASC extends to spontaneous interpretation of moral dilemmas. This new film task has the potential to assay different aspects of how the social world is represented differently in ASC, including during moral comprehension. [source] The challenge of caring for patients in pain: from the nurse's perspectiveJOURNAL OF CLINICAL NURSING, Issue 20 2009Katrin Blondal Aim., To increase understanding of what it is like for nurses to care for patients in pain. Background., Hospitalised patients are still suffering from pain despite increased knowledge, new technology and a wealth of research. Since nurses are key figures in successful pain management and research findings indicate that caring for suffering patients is a stressful and demanding experience where conflict often arises in nurses' relations with patients and doctors, it may be fruitful to study nurses' experience of caring for patients in pain to increase understanding of the above problem. Design., A phenomenological study involved 20 dialogues with 10 experienced nurses. Results., The findings indicate that caring for a patient in pain is a ,challenging journey' for the nurse. The nurse seems to have a ,strong motivation to ease the pain' through moral obligation, knowledge, personal experience and conviction. The main challenges that face the nurse are ,reading the patient', ,dealing with inner conflict of moral dilemmas', ,dealing with gatekeepers' (physicians) and ,organisational hindrances'. Depending upon the outcome, pain management can have positive or negative effects on the patient and the nurse. Conclusions., Nurses need various coexisting patterns of knowledge, as well as a favourable organisational environment, if they are to be capable of performing in accord with their moral and professional obligations regarding pain relief. Nurses' knowledge in this respect may hitherto have been too narrowly defined. Relevance to clinical practice., The findings can stimulate nurses to reflect critically on their current pain management practice. By identifying their strengths as well as their limitations, they can improve their knowledge and performance on their own, or else request more education, training and support. Since nurses' clinical decisions are constantly moulded and stimulated by multiple patterns of knowledge, educators in pain management should focus not only on theoretical but also on personal and ethical knowledge. [source] |