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1.
Artif Life ; : 1-23, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38656414

RESUMEN

The field of Artificial Life studies the nature of the living state by modeling and synthesizing living systems. Such systems, under certain conditions, may come to deserve moral consideration similar to that given to nonhuman vertebrates or even human beings. The fact that these systems are nonhuman and evolve in a potentially radically different substrate should not be seen as an insurmountable obstacle to their potentially having rights, if they are sufficiently sophisticated in other respects. Nor should the fact that they owe their existence to us be seen as reducing their status as targets of moral concern. On the contrary, creators of Artificial Life may have special obligations to their creations, resembling those of an owner to their pet or a parent to their child. For a field that aims to create artificial life-forms with increasing levels of sophistication, it is crucial to consider the possible ethical implications of our activities, with an eye toward assessing potential moral obligations for which we should be prepared. If Artificial Life is larger than life, then the ethics of artificial beings should be larger than human ethics.

2.
J Health Popul Nutr ; 43(1): 56, 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38664782

RESUMEN

Due to rising popularity of vegetarianism in recent years, research interest has surged in examining the relationship between vegetarianism and psychological health. However, given inconsistent findings in prior research, the answer to whether practicing vegetarianism is associated with better or worse psychological health is still elusive. The present investigation aimed to demonstrate that vegetarians are not homogeneous in terms of psychological experiences, such that it is crucial to consider the motives behind vegetarians' dietary choice when examining their psychological health. In a survey study with 266 vegetarians and 104 omnivores, it was shown that health vegetarians displayed higher levels of disordered eating as compared to moral vegetarians and omnivores. Mediation analyses further revealed that, among vegetarians, health motivation was positively correlated with disordered eating tendencies, indirectly linking it with poorer psychological health; moral motivation was positively correlated with prosocial behavior, which in turn predicted better psychological health. These findings have implications for understanding the psychological health of vegetarians with different dietary motives and for developing interventions to promote their psychological health.


Asunto(s)
Dieta Vegetariana , Salud Mental , Principios Morales , Motivación , Vegetarianos , Humanos , Femenino , Masculino , Vegetarianos/psicología , Adulto , Dieta Vegetariana/psicología , Adulto Joven , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios
3.
Front Hum Neurosci ; 18: 1329628, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38665898

RESUMEN

Prototype theory, which argues that categories have graded (and thus fuzzy) membership based on prototypes, has been used as cognitive evidence to support moral particularism because if categories (in moral rules) only have fuzzy conceptual boundaries, moral rules are not enough for moral judgment, as specific situations also need to be considered to determine how these fuzzy categories should be understood, which is what moral particularism believes. The importance of literature for ethics, especially for moral imagination, has also been extensively discussed because literature can provide vivid examples for us to imagine different moral dilemmas, the consequences of different moral choices, and the feelings of different people facing different situations. Martha Nussbaum specifically argues that the literary form is the only adequate form to imagine certain complex moral situations. By analyzing concrete literary examples as well as the related ethical discussions and empirical findings, this article argues that, building on Nussbaum's argument, prototype theory can serve as a cognitive basis for the importance of literary form for moral imagination, because the literary form's tolerance of ambiguity suits how we ambiguously categorize the world.

4.
Nurs Open ; 11(4): e2163, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38642075

RESUMEN

AIM: To determine the relationship between psychological resilience, nursing practice environment, and moral courage of clinical nurses and also the factors influencing moral courage. DESIGN: Cross-sectional study. METHODS: 586 nurses from a general hospital were selected by convenience sampling method in January 2023. The general information questionnaire, Nurses' Moral Courage Scale (NMCS), Resilience Scale, and Practice Environment Scale (PES) were measured. Hierarchical linear regression analysis was used to explore the influencing factors of clinical nurses' moral courage. RESULTS: Nurses' average moral courage score was 79.00 (69.00, 91.00). The nurses' moral courage was positively correlated with psychological resilience and nursing practice environment. Multivariate linear regression analysis showed that psychological resilience and nursing practice environment entered the regression equation, accounting for 23.4% of the total variation. Psychological resilience and nursing practice environment are the main factors affecting the moral courage of clinical nurses. Nursing managers should conduct moral courage training, develop a decent nursing practice environment, pay attention to the psychological emotions of nurses, and actively build a safe, open, and supportive atmosphere for moral behaviour.


Asunto(s)
Coraje , Enfermeras Administradoras , Resiliencia Psicológica , Humanos , Estudios Transversales , Principios Morales
5.
BMC Health Serv Res ; 24(1): 481, 2024 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-38637814

RESUMEN

BACKGROUND: Healthcare providers may experience moral distress when they are unable to take the ethically or morally appropriate action due to real or perceived constraints in delivering care, and this psychological stressor can negatively impact their mental health, leading to burnout and compassion fatigue. This study describes healthcare providers experiences of moral distress working in long-term care settings during the COVID-19 pandemic and measures self-reported levels of moral distress pre- and post-implementation of the Dementia Isolation Toolkit (DIT), a person-centred care intervention designed for use by healthcare providers to alleviate moral distress. METHODS: Subjective levels of moral distress amongst providers (e.g., managerial, administrative, and front-line employees) working in three long-term care homes was measured pre- and post-implementation of the DIT using the Moral Distress in Dementia Care Survey and semi-structured interviews. Interviews explored participants' experiences of moral distress in the workplace and the perceived impact of the intervention on moral distress. RESULTS: A total of 23 providers between the three long-term care homes participated. Following implementation of the DIT, subjective levels of moral distress measured by the survey did not change. When interviewed, participants reported frequent experiences of moral distress from implementing public health directives, staff shortages, and professional burnout that remained unchanged following implementation. However, in the post-implementation interviews, participants who used the DIT reported improved self-awareness of moral distress and reductions in the experience of moral distress. Participants related this to feeling that the quality of resident care was improved by integrating principals of person-centered care and information gathered from the DIT. CONCLUSIONS: This study highlights the prevalence and exacerbation of moral distress amongst providers during the pandemic and the myriad of systemic factors that contribute to experiences of moral distress in long-term care settings. We report divergent findings with no quantitative improvement in moral distress post-intervention, but evidence from interviews that the DIT may ease some sources of moral distress and improve the perceived quality of care delivered. This study demonstrates that an intervention to support person-centred isolation care in this setting had limited impact on overall moral distress during the COVID-19 pandemic.


Asunto(s)
Agotamiento Profesional , COVID-19 , Demencia , Humanos , Cuidados a Largo Plazo , Pandemias , Personal de Salud/psicología , Agotamiento Profesional/prevención & control , COVID-19/epidemiología , Principios Morales , Demencia/terapia
6.
BMC Psychol ; 12(1): 225, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38654390

RESUMEN

BACKGROUND: Academic procrastination is a widespread phenomenon among students. Therefore, evaluating the related factors has always been among the major concerns of educational system researchers. The present study aimed to determine the relationship of academic procrastination with self-esteem and moral intelligence in Shahroud University of Medical Sciences students. METHODS: This cross-sectional descriptive-analytical study was conducted on 205 medical sciences students. Participants were selected based on inclusion and exclusion criteria using the convenience sampling technique. The data collection tools included a demographic information form, Solomon and Rothblum's Procrastination Assessment Scale-Students, Rosenberg Self-Esteem Scale, and Lennick and Kiel's Moral Intelligence Questionnaire, all of which were completed online. The data were analyzed using descriptive statistics and inferential tests (multivariate linear regression with backward method) in SPSS software. RESULTS: 96.1% of participating students experienced moderate to severe levels of academic procrastination. Based on the results of the backward multivariate linear regression model, the variables in the model explained 27.7% of the variance of academic procrastination. Additionally, self-esteem (P < 0.001, ß=-0.942), grade point average (P < 0.001, ß=-2.383), and interest in the study field (P = 0.006, ß=-1.139) were reported as factors related to students' academic procrastination. CONCLUSION: According to the findings of this study, the majority of students suffer from high levels of academic procrastination. Furthermore, this problem was associated with low levels of self-esteem, grade point average, and interest in their field of study.


Asunto(s)
Procrastinación , Autoimagen , Estudiantes de Medicina , Humanos , Estudios Transversales , Masculino , Femenino , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Adulto Joven , Adulto , Principios Morales , Encuestas y Cuestionarios , Inteligencia , Irán
7.
PeerJ Comput Sci ; 10: e1912, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38660202

RESUMEN

Multimodal emotion recognition techniques are increasingly essential for assessing mental states. Image-based methods, however, tend to focus predominantly on overt visual cues and often overlook subtler mental state changes. Psychophysiological research has demonstrated that heart rate (HR) and skin temperature are effective in detecting autonomic nervous system (ANS) activities, thereby revealing these subtle changes. However, traditional HR tools are generally more costly and less portable, while skin temperature analysis usually necessitates extensive manual processing. Advances in remote photoplethysmography (r-PPG) and automatic thermal region of interest (ROI) detection algorithms have been developed to address these issues, yet their accuracy in practical applications remains limited. This study aims to bridge this gap by integrating r-PPG with thermal imaging to enhance prediction performance. Ninety participants completed a 20-min questionnaire to induce cognitive stress, followed by watching a film aimed at eliciting moral elevation. The results demonstrate that the combination of r-PPG and thermal imaging effectively detects emotional shifts. Using r-PPG alone, the prediction accuracy was 77% for cognitive stress and 61% for moral elevation, as determined by a support vector machine (SVM). Thermal imaging alone achieved 79% accuracy for cognitive stress and 78% for moral elevation, utilizing a random forest (RF) algorithm. An early fusion strategy of these modalities significantly improved accuracies, achieving 87% for cognitive stress and 83% for moral elevation using RF. Further analysis, which utilized statistical metrics and explainable machine learning methods including SHapley Additive exPlanations (SHAP), highlighted key features and clarified the relationship between cardiac responses and facial temperature variations. Notably, it was observed that cardiovascular features derived from r-PPG models had a more pronounced influence in data fusion, despite thermal imaging's higher predictive accuracy in unimodal analysis.

8.
Heliyon ; 10(8): e29112, 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38644810

RESUMEN

Background: Road rage is a common phenomenon during driving, which not only affects the psychological health of drivers but also may increase the risk of traffic accidents. This article explores the impact of moral disengagement and anger rumination on road rage through two studies. Method: This research combined experimental studies with survey questionnaires. Study one used a driving simulator to investigate whether moral disengagement and anger rumination are psychological triggers of road rage in real-time driving, and whether there are differences in the main psychological triggers of road rage under different road scenarios. Building on the first study, study two employed a survey questionnaire to analyze the relationship between moral disengagement, anger rumination, and road rage. Participants in both studies were drivers with certain driving ages and experience. Data were processed and analyzed using descriptive statistics, factor analysis, reliability and validity tests, and multiple regression analysis. Results: The findings indicated: (1) There were significant differences in the anger induction rate across different road scenarios, χ2 = 35.73, p < 0.01, effect size = 0.29. Significant differences in average anger levels were observed in scenarios involving oncoming vehicles, lane-cutting, sudden stops by the vehicle ahead, pedestrians crossing the road, and traffic congestion (F = 20.41, p < 0.01, ηp2 = 0.36), with anger rumination playing a major role in the formation of road rage; (2) Moral disengagement significantly predicted road rage (ß = 0.25, t = 3.85, p < 0.01). The predictive effect of moral disengagement on anger rumination was significant (ß = 0.39, t = 6.17, p < 0.01), as was the predictive effect of anger rumination on road rage (ß = 0.43, t = 6.3, p < 0.01). The direct effect of moral disengagement on road rage included 0 in the bootstrap 95% confidence interval, while the mediating effect of anger rumination did not include 0 in the bootstrap 95% confidence interval, indicating that anger rumination fully mediated the relationship between moral disengagement and road rage.

9.
Front Psychol ; 15: 1308304, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38646125

RESUMEN

In an age of mass communication, citizens need to learn how to detect and transmit reliable scientific information. This need is exacerbated by the transmission of news through social media, where any individual has the potential to reach thousands of other users. In this article, we argue that fighting the uncontrolled transmission of unreliable information requires improved training in broad epistemic integrity. This subcategory of research integrity is relevant to students in all disciplines, and is often overlooked in integrity courses, in contrast to topics such as fraud, plagiarism, collaboration and respect for study subjects. Teaching epistemic integrity involves training epistemic skills (such as metacognitive competences, capacity to use helpful heuristics, basic statistical and methodological principles) and values (such as love of truth, intellectual humility, epistemic responsibility). We argue that this topic should be addressed in secondary school, and later constitute a fundamental component of any university curriculum.

10.
Behav Sci (Basel) ; 14(4)2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38667079

RESUMEN

Moral injury syndrome (MIS) is a mental health (MH) problem that substantially affects resilience; the presence of MIS reduces responsiveness to psychotherapy and increases suicide risk. Evidence-based treatment for MIS is available; however, it often goes untreated. This project uses principles of the Consolidated Framework for Implementation Research (CFIR) to assess barriers and facilitators to the implementation of Building Spiritual Strength (BSS), a multi-disciplinary treatment for MIS. Interviews were conducted with chaplains and mental health providers who had completed BSS facilitator training at six sites in the VA. Data were analyzed using the Hamilton Rapid Turnaround method. Findings included multiple facilitators to the implementation of BSS, including its accessibility and appeal to VA chaplains; leadership by VA chaplains trained in the intervention; and effective collaboration between the chaplains and mental health providers. Barriers to the implementation of BSS included challenges in engaging mental health providers and incorporating them as group leaders, veterans' lack of familiarity with the group format of BSS, and the impact of the COVID-19 pandemic. Results highlight the need for increased trust and collaboration between VA chaplains and mental health providers in the implementation of BSS and treatment of MIS.

11.
Pediatr Nephrol ; 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38668777

RESUMEN

BACKGROUND: The circumstances surrounding chronic kidney disease and its impact on families can be complex and difficult to navigate, leading to these cases being labeled "challenging." CASE PRESENTATION: We present the case of an adolescent with kidney failure due to unremitting systemic illness and multiple complications ultimately resulting in the family's request to forgo dialysis. Medical team members wrestled with meeting the family's needs among internal and external constraints. CONCLUSION: Past experiences, systemic inequities, differing perspectives, and consequential decision-making within individual belief systems can lead to friction between and among medical team members and families. As pediatric nephrologists, we must shift our focus from the "challenging" patient or family to addressing what is challenging their ability to flourishing.

12.
Cognition ; 247: 105773, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38564850

RESUMEN

Charges of hypocrisy are usually thought to be to be damning. Yet when a hypocrisy charge is made, there often remains disagreement about whether or not its target really is a hypocrite. Why? Three pre-registered experiments (N = 2599) conceptualize and test the role of perceived comparability in evaluating hypocrisy. Calling someone a hypocrite typically entails invoking a comparison-one meant to highlight internal contradiction and cast moral character into question. Yet there is ambiguity about which sorts of comparisons are valid in the first place. We argue that disagreements about moral hypocrisy often boil down to disagreements about comparability. Although the comparability of two situations should not depend on whose behavior is being scrutinized, observers shift comparability judgments in line with social motives to criticize or defend. In short, we identify a cognitive factor that can help to explain why, for similar patterns of behavior, people see hypocrisy in their enemies but consistency in themselves and their allies.

13.
Nurs Ethics ; : 9697330241246086, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38626781

RESUMEN

BACKGROUND: Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding end-of-life care and its consequential impacts. RESEARCH OBJECTIVES: To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. RESEARCH DESIGN: A qualitative descriptive approach was employed. PARTICIPANTS AND RESEARCH CONTEXT: Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. ETHICAL CONSIDERATIONS: We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. FINDINGS: The moral distress-inducing factors and nurses' perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. CONCLUSIONS: End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress.

14.
Nurs Ethics ; : 9697330241246089, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38628067

RESUMEN

BACKGROUND: Moral distress has negative effects on physical and mental health. However, there is little information about nurses' coping strategies reducing moral distress. AIM: The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran. STUDY DESIGN: This is a qualitative study with a content analysis approach. PARTICIPANTS AND RESEARCH CONTEXT: The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran University of Medical Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman's (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study. ETHICAL CONSIDERATIONS: This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed. FINDING: The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment). DISCUSSION: The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses' preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees.

15.
J Psychiatr Res ; 173: 326-332, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38574596

RESUMEN

BACKGROUND: Race-related stress (RRS) is an unrecognized source of moral injury (MI)-or the emotional and/or spiritual suffering that may emerge after exposure to events that violate deeply held beliefs. Additionally, MI has not been explored as a mechanism of risk for post-traumatic stress disorder (PTSD) in trauma-exposed civilians. We examined relations among exposure to potentially morally injurious events (moral injury exposure, MIE), related distress (moral injury distress, MID), and RRS in Black Americans. Potential indirect associations between RRS and PTSD symptoms via MID were also examined. METHODS: Black Americans (n = 228; 90.4% female; Mage = 31.6 years. SDage = 12.8 years) recruited from an ongoing study of trauma completed measures assessing civilian MIE and MID, RRS, and PTSD. Bivariate correlations were conducted with MIE and MID, and mediation analysis with MID, to examine the role of MI in the relationship between RRS and PTSD symptom severity. RESULTS: MIE was significantly correlated with cultural (r = 0.27), individual (r = 0.29), and institutional (r = 0.25) RRS; MID also correlated with cultural (r = 0.31), individual (r = 0.31), and institutional (r = 0.26) RRS (ps < 0.001). We found an indirect effect of RRS on PTSD symptoms via MID (ß = 0.10, p < 0.005). CONCLUSIONS: All types of RRS were associated with facets of MI, which mediated the relationship between RRS and current PTSD symptoms. MI may be a potential mechanism through which RRS increases the risk for PTSD in Black individuals.


Asunto(s)
Principios Morales , Trastornos por Estrés Postraumático , Adulto , Femenino , Humanos , Masculino , Ansiedad , Negro o Afroamericano , Emociones , Estudios Longitudinales , Trastornos por Estrés Postraumático/complicaciones , Adulto Joven
16.
Front Psychol ; 15: 1355736, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38558780

RESUMEN

In recent years, the emotional experience of climate change has been studied extensively from fields like psychology, theology, sociology, and philosophy. It is crucial to analyze these results for possible vulnerability with regard to well-being. While climate justice research raises awareness of the current (social) situation of the participants in relation to the experience of climate change, the research on climate emotions seems to overlook the participant's former social situation - their family of origin. Previous studies on injustice have shown however that it is precisely the way people were educated on emotion work that has a significant impact on their experiences and sense of control in the situation. Given the importance of this sense of control for mental well-being, I argue consequently that social origin is a vulnerability for well-being in the (emotional) experience of climate change, perpetuating climate injustice, based on this combination of studies from different epochs. Therefore, in the interest to protect well-being on a warming planet, it is crucial to raise awareness of the impact of social origin.

17.
Clin Neuropsychiatry ; 21(1): 63-78, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38559430

RESUMEN

Objective: Fear of moral guilt and conseque:nt increased attention to personal actions and intentions are the main ingredients of the self-criticism in patients suffering from obsessive-compulsive disorder (OCD). This pathogenic attitude takes shape in a typical guilt-inducing self-talk.The purpose of this work is to describe in detail a novel cognitive therapeutic procedure for OCD called "Dramatized Socratic Dialogue" (DSD). Method: DSD is a theory-oriented intervention that combine elements of Socratic dialogue, chairwork, and cognitive acceptance strategies derived from Mancini's model, which posits that obsessive-compulsive (OC) symptoms stem from a fear of deontological guilt. Results: DSD appears to have many strengths, being a theory-oriented treatment and focusing, as a therapeutic target, on the cognitive structures that determine pathogenic processes and OC symptoms. Furthermore, it is a short, flexible and tailor-made intervention. Conclusions: Detailed description of the intervention could foster future research perspectives and thus be used in evidence-based effectiveness studies to establish whether DSD reduces OC symptoms and to investigate its mechanism of action.

18.
J Intensive Care Med ; : 8850666241245933, 2024 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-38571401

RESUMEN

INTRODUCTION: By using a novel survey our study aimed to assess the challenges ECMO and Critical Care (CC) teams face when initiating and managing patient's ECMO support. METHODS: A qualitative survey-based observational study was performed of members of 2 Critical Care Medicine organizations involved in decision-making around the practice of Extracorporeal Membrane Oxygenation (ECMO). The range of exploratory questions covered ethical principles of informed consent, autonomy and goals of care discussions, beneficence, non-maleficence (offering life-sustaining treatments in end-of-life care), and justice (insurance-related limitations of treatment). Questions also covered pragmatic practice and quality improvement areas, such as exploring whether palliative care or ethics teams were involved in such decision-making. RESULTS: 305 members received the survey links, and a total of 61 completed surveys were received, for an overall response rate of 20% among all eligible members. Only 70% of the participants who manage ECMO patients are involved in the ECMO initiation decision process. The majority do not involve Ethics or Palliative care at the initial ECMO initiation decision step. Of the ethical and moral dilemmas reported, the majority revolved around 1. Prognostication of patients receiving VV and VA ECMO support, 2. Lack of knowledge of patient's wishes and goals, 3. Disconnect between expectations of families and outcomes and 4. Staff moral distress around when to stop ECMO in case of futility. CONCLUSION: Our survey highlights areas of distress and dilemma which have been stressed before in the initiation, management, and outcomes of ECMO patients, however with the increasing use of this modality of cardiopulmonary mechanical support being offered, the survey results can offer a guidance using sound ethical principles.

19.
Artículo en Inglés | MEDLINE | ID: mdl-38573406

RESUMEN

Priority-setting policy-makers often face moral and political pressure to balance the conflicting motivations of efficiency and rescue/non-abandonment. Using the conflict between these motivations as a case study can enrich the understanding of institutional design in developed democracies. This essay presents a cognitive-psychological account of the conflict between efficiency and rescue/non-abandonment in health care priority-setting. It then describes three sets of institutional arrangements-in Australia, England/Wales, and Germany, respectively-that contend with this conflict in interestingly different ways. The analysis yields at least three implications for institutional design in developed democracies: (1) indeterminacy at the level of moral psychology can increase the probability of indeterminacy at the level of institutional design; (2) situational constraints in effect require priority-setting policy-makers to adopt normative-moral pluralism; and (3) the U.S. health care system may be in an anti-priority-setting equilibrium.

20.
Front Psychol ; 15: 1269552, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38572202

RESUMEN

People sometimes protest government corruption, yet our current understanding of why they do so is culturally constrained. Can we separate pancultural factors influencing people's willingness to protest government corruption from factors culturally specific to each socioecological context? Surprisingly little cross-cultural data exist on this important question. To fill this gap, we performed a cross-cultural test of the Axiological-Identitary Collective Action Model (AICAM) regarding the intention to protest against corruption. As a collective action framework, AICAM integrates three classical antecedents of collective action (injustice, efficacy, identity) with axiological variables (ideology and morality). A total sample of 2,316 participants from six countries (Nigeria, Russia, India, Spain, United States, Germany) in a multilevel analysis of AICAM predictions showed that the positive relationship of the intention to protest corruption with moral obligation, system-based anger, and national identification can be considered pancultural. In contrast, the relationships between system justification and perceived efficacy are culturally specific. System justification negatively predicted the intention to participate only in countries with high levels of wealth, while perceived efficacy positively predicted it only in countries perceived as less corrupt. These findings highlight the importance of accounting features of socioecology and separating pancultural from culture-specific effects in understanding collective action.

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