How the COVID-19 pandemic affects the moral reasoning of pediatric residents and the general population.

BACKGROUND: Kohlberg's theory of moral development asserts that people progress through different stages of moral reasoning as their cognitive abilities and social interactions mature. Individuals at the lowest stage of moral reasoning (preconventional stage) judge moral issues based on self-interest, those with a medium stage (conventional stage) judge them based on compliance with rules and norms, and those at the highest stage (postconventional stage) judge moral issues based on universal principles and shared ideals. Upon attaining adulthood, it can be considered that there is stability in the stage of individuals' moral development; however, the effect of a global population crisis such as the one experienced in March 2020, when the World Health Organization (WHO) declared the COVID-19 pandemic, is unknown. The purpose of this study was to evaluate the changes in the moral reasoning of pediatric residents before and after one year of the COVID-19 pandemic and compare them with a general population group. METHODS: This is a naturalistic quasi-experimental study conducted with two groups, one comprised 47 pediatric residents of a tertiary hospital converted into a COVID hospital during the pandemic and another group comprised 47 beneficiaries of a family clinic who were not health workers. The defining issues test (DIT) was applied to the 94 participants during March 2020, before the pandemic initiated in Mexico, and later during March 2021. To assess intragroup changes, the McNemar-Bowker and Wilcoxon tests were used. RESULTS: Pediatric residents showed higher baseline stages of moral reasoning: 53% in the postconventional group compared to the general population group (7%). In the preconventional group, 23% were residents and 64% belonged to the general population. In the second measurement, one year after the start of the pandemic, the group of residents had a significant decrease of 13 points in the P index, unlike the general population group in which a decrease of 3 points was observed. This decrease however, did not equalize baseline stages. Pediatric residents remained 10 points higher than the general population group. Moral reasoning stages were associated with age and educational stage. CONCLUSIONS: After a year of the COVID-19 pandemic, we found a decrease in the stage of moral reasoning development in pediatric residents of a hospital converted for the care of patients with COVID-19, while it remained stable in the general population group. Physicians showed higher stages of moral reasoning at baseline than the general population.

Wave after wave: unboxing 40 years of auditing ethics research

Purpose - To the best of the authors' knowledge, this is the first study that aims to present a comprehensive view of the auditing ethics literature by unboxing 40 years of efforts in the field. Design/methodology/approach - This study combined bibliometric, social network and content analysis by analyzing 114 articles published in accounting and top business ethics journals on the Web of Science database from 1980 to 2021.Findings - The results show a rising interest in this topic and reveal auditors' ethical decision-making and moral reasoning as the most discussed topics in the literature. The work also clusters the literature according to keywords and scopes, identifying literature gaps and suggesting new avenues for future research.Practical implications - The research results assist provide an overarching image of the auditing ethics field. In addition, these results draw possible future avenues to bridge the void in the current auditing ethics literature by presenting indispensable directions for potential research. For example, future research could pay more attention to whistleblowing, fraud, personal auditor characteristics, auditor ethical sensitivity, auditor ethical conflict, ethical climate and underreporting of time. Moreover, the rapidly changing business environment necessitates the auditing ethics research to move to more practical implications to mitigate previous mistakes and avoid any future risks.Originality/value - All crises are an ideal breeding ground to motivate fraud and audit failures. In fact, auditing ethics research has been subordinated to the different economic crises. However, despite increasing awareness of the topic's relevance, no comprehensive study focuses on auditing ethics literature. Now, the devastating effects of the COVID-19 crisis are producing a new wave of financial distresses and avoiding former mistakes is timelier than ever. With this novel and integrated approach, this work goes one step forward, developing a comprehensive picture of the auditing ethics literature.

From pharmacy student to pharmacist: Exploring the journey of moral development

Introduction: It is widely accepted that the role of a pharmacist is becoming more complex and the scope of practice has broadened over the past decade. With restricted access to hospitals and general practice, the COVID-19 pandemic shone a light on the vital role that pharmacists play in maintaining patient care and disease management. Pharmacists have always been at the forefront delivering safe and effective care across all settings. Recent reforms to the education and training of pharmacists in the United Kingdom, will see that from day one on the register, pharmacists are expected to play an active role in the provision of clinical care and consultations including prescribing medicines. These advances make it more important now to have a better understanding of what moral development through pharmacy education and once in practice. Research has shown that healthcare professionals can make better decisions in the interests of their patients when they have advanced levels of moral decision making. Objective(s): It is hypothesised that as students' progress through pharmacy education they will demonstrate maturation in moral development, and this should continue as they progress through their careers. This research intends to measure and evaluate the pattern of moral reasoning of undergraduate pharmacy students at the University of Hertfordshire (UH) as they progress through formal education and practice. Method(s): A ten-year longitudinal study which employed the Defining Issues Test 2 (DIT2) to quantitatively measure the changes the participants' moral development. The DIT2 was completed by participants of a single cohort of students, who started the Master of Pharmacy (M.Pharm.) programme in 2008 in each year of study at the University of Hertfordshire, once after passing the General Pharmaceutical Council pharmacist registration exam (as Newly Qualified pharmacists) and a final time five years after they qualified (as matured Established Practitioners). Medians and standard deviations were calculated and compared analysed using pairwise comparison with the Wilcoxon signed-rank test. Result(s): The statistically significant changes were in N2 scores between Level 1 (Median = 22.07) and Level 3 (Median = 26.80) (p = 0.025), this is a positive finding which supports the research that shows that moral development can be taught. To further support these results there was an increase in N2 score between Level 1 and Level 4 (p = 0.011). Research has also shown that practice-based experience can give rise to maturation in moral development, this research showed a statistically significant difference between Level 4 (Median = 22.62) and NQ Level (Median = 40.53). Despite this, surprisingly, there was a marked decrease in p and N2 scores at Established Practitioner level. Conclusion(s): Overall, the research showed a general increase in moral development as the participants progressed through the M.Pharm. programme and in the first year after qualifying. However, with the decrease in moral development indices as an Established Practitioner qualitative research to investigate factors that may have caused this then recommend ways to support pharmacists better through education and practice.

All People.

In early March 2020, the March-April Hastings Center Report was very nearly assembled and contained nothing about Covid-19, which was still just beginning to make itself publicly known in the United States. Two weeks later, the editorial line-up was undergoing a remix, and essays that lay out sweeping agendas for the response to the worldwide crisis were in preparation. The central theme in the agenda that Lawrence O. Gostin and colleagues develop is that the pandemic requires a sharp break from usual ethical norms yet simultaneously demands a return to core ethical commitments. A similar theme is sounded by Mildred Z. Solomon and colleagues in a commentary calling for federal actions to keep the health care system functioning. Other essays in the issue take up an assortment of topical issues-including international patient dumping-that were simmering along prior to the pandemic, and the two articles take up foundational questions about the nature of moral reasoning.

How German and Italian Laypeople Reason about Distributive Shortages during COVID-19.

(1) Background: The COVID-19 pandemic provided a unique opportunity to investigate how moral reasoning is influenced by individuals' exposure to a crisis and by personal, societal and temporal proximity. We examined how Italians and Germans judged different behaviors that arose because of the pandemic, which affected health and societal matters. (2) Methods: Over the course of four months and three assessment periods, we used an observational online survey to assess participants' judgments regarding seven scenarios that addressed distributive shortages during the pandemic. (3) Results: Overall, there was no clear answering pattern across all scenarios. For a variation of triage and pandemic restrictions, most participants selected a mean value, which can be interpreted as deferring the choice. For the other scenarios, most participants used the extremes of the scale, thereby reflecting a clear opinion of the public regarding the moral issue. In addition, moral reasoning varied across the two countries, assessment periods, fear, and age. (4) Conclusions: By using scenarios that were taken from real-life experiences, the current study addresses criticism that moral research mostly relies on unrealistic scenarios that lack in external validity, plausibility, and proximity to everyday situations. In addition, it shows how lay people regard measures of public health and societal decision-making.

CSR and CEO's Moral Reasoning in the Automotive Industry in the Era of COVID-19

This paper assesses whether and to which extent the COVID-19 pandemic, which represents a scenario of high moral intensity, is influencing the moral reasoning of top CEOs (chief executive officers) in the paradigmatic case of the automotive industry and how this moral reasoning relates to their CSR response to the crisis and their CSR plans in the long run. To this end, we took the CEO letters before and after the pandemic outbreak of the top 15 automotive companies, and applied Weber's method to conduct a moral reasoning categorization, along with an examination of their CSR approach and initiatives. The results show a predominant moral paralysis among these CEOs, where positive reactions addressed are philanthropic in nature and more likely to be a transient response to the crisis, rather than a sustained long-term improvement of their CSR rooted in a significant moral approach enhancement. Furthermore, CEOs at the lowest stages of moral reasoning, primarily focused on their own business and immediate stakeholders, are less likely to highlight these philanthropic initiatives. The outcome evidences the convenience of addressing CSR from the lens of moral reasoning, and it further draws the attention of the scientific community, companies and their top management, stakeholders, and society to the relevance of investigating and considering the moral reasoning of top management in large corporations and its implications.

Coping with COVID-19: Insights from cognition and emotion research.

Since March 2020, the COVID-19 pandemic and ensuing efforts to contain its spread have caused major problems with public health, along with social and economic disruptions. This Special Issue addresses how coping with the pandemic has been shaped by the interplay between cognition and emotion. The various contributions to this Special Issue explore the impacts of the pandemic on: (a) How people were confronted with new risks and realities; (b) Active processes of emotional resilience and ruminative coping; and c) Moral decision-making. Taken together, this work shows how research on cognition and emotion can illuminate the social and emotional strains of the pandemic, while helping to identify risk factors that exacerbate these problems and pointing to ways to successfully address and mitigate these problems, such as emotion regulation, social support, and perspective taking. The editorial closes by briefly reporting on the present state of the journal and changes in the editorial team.

Revisiting the association between executive function and social competence: A process-oriented account of social and moral development

The goal of the current dissertation study was to examine the longitudinal association between executive function (EF) and social competence (SC). Previous research has shown that SC in peer conflict situations is an important skill and that EF supports the development of SC during preschool. However, less is known about the mechanism by which EF supports SC development. In addition, there is evidence to suggest that not all children require the same level of EF to behave in a competent manner. The current study explored the possibility that children's temperament or moral reasoning abilities differentiated between these children. The secondary goal of the study was to examine how EF and classroom behavior contributed to children's moral development over the preschool year.To address these goals, 86 4- to 5-year-old children were tested at the beginning of the preschool year (T1) and 33 of these children (because of retention difficulties associated with COVID-19) were tested during the summer following the preschool year (T2). Participants completed a social problem solving task, a moral reasoning interview, and an EF task battery at both time points. Parents completed a temperament questionnaire at T1 and teachers reported on children's classroom behavior at T2. Results revealed that T1 EF predicted SC, but only for participants high in temperamental surgency. T1 EF additionally predicted T2 moral reasoning, but in opposite directions depending on participants' classroom prosocial behavior. The results broadly provide support for current theories regarding the development of both SC and moral reasoning during the preschool years. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

'Prescription' for Purposeful Adaptation of Professionalism-and-Ethics Teaching Strategies for Remote Delivery.

This case report outlines the strategies underpinning the adaptation of professionalism and ethics strand (P&E) teaching for remote delivery on a Pharmacy programme in response to COVID-19 restrictions. In line with national and University guidance, P&E teaching detailed in this report was delivered online in late 2020. Sessions were generally live and recorded, although some content was pre-recorded using video-capture software. All learning activities, recordings and supporting resources are accessible to students on the University's Virtual Learning Environment. This report reflects on the curriculum, pedagogy and content of P&E teaching, with particular emphasis on teaching related to professional identity formation and moral reasoning competencies development. Design, development and delivery of remote online teaching is considered in the context of P&E teaching. Strategies used to plan for adaptation and delivery of interactive online teaching sessions aligned with P&E teaching are described. Key findings support a scholarship of teaching approach when planning for adaptation to remote online teaching. Purposeful consideration of existing curricular, pedagogical and instructional design enables the teacher to identify critical P&E teaching activities potentially compromised by the move to the online environment. Informed integration of available instructional tools to teaching activities follows. The report concludes with recommendations for future research.