重症监护病房护士道德勇气与道德困境的相关性研究

通过对824名ICU护士的调查,发现个人因素（如性别、年龄、婚姻）和职业状态（如职称、工作经验、收入）显著影响道德勇气与道德困境的关系。研究指出,道德勇气的各维度与道德困境的经历呈现出负相关,显示具有高伦理操守和承诺的护士更能在伦理挑战中保持其标准。同时,道德责任感强的护士在实际工作中更频繁遭遇道德困境。研究强调,为增强ICU护士的道德勇气,减少道德困境,医院管理层应加强指导和心理支持,推动积极的伦理环境建设。这为提高ICU护理服务质量、优化护士伦理决策提供了实证基础,对促进护理领域伦理教育和管理具有重要意义。

     

新生儿ICU护士道德困境研究进展

新生儿ICU护士由于工作环境与护理对象的特殊性,极易产生道德困境。目前有多种道德困境评估工具用以评估新生儿ICU护士道德困境,大多数新生儿ICU护士对道德困境认知清晰,道德困境水平较高;护士的权限、治疗和护理措施对患儿预后的影响、团队合作等情景是新生儿ICU护士道德困境的来源。道德困境使新生儿ICU护士产生了负面心理,降低了护士的工作积极性,不利于临床工作的开展,应重视新生儿ICU护士道德困境问题,采取措施以改善新生儿ICU护士道德困境,降低道德困境对新生儿ICU护士的负面影响。

     

朱熹浩然之气、道德认知与道德勇气述论

浩然之气是儒家道德哲学的重要伦理命题。朱熹在其理学构架内重新对“浩然之气”进行诠释,在他看来,“知言”是养成浩然之气的关键,亦即要通过道德认知的方式涵养出道德勇气,将血气转化为浩气。如此养成的浩气,可以推动道德实践的落实,使人以一种无所疑虑、恐惧的状态去实践。浩气具有道德实践能力,即在朱熹的思想当中,气不是纯然消极的,气可以有积极的面向,这也是“浩然之气”道德性的重要展现。“浩然之气”作为“道德勇气”其时代价值也就能更充分地展现出来,即今天依旧需要具有道德实践力、能抗风险、坚守价值的道德主体,此种道德主体必定是一身浩气。     

ICU护士伦理气氛认知与道德困境的相关性研究

采用量性研究方法对ICU护士进行调查分析,了解ICU护士道德困境和伦理气氛认知的现状,并探讨两者之间的相关性。结果显示,ICU护士道德困境总分为43.00分(24.00, 67.00),伦理气氛认知得分为(3.44±0.38)分。相关性分析结果显示：道德困境总分与关怀型伦理气氛呈负相关(r=-0.131,P＜0.05),与功利型伦理气氛呈正相关(r=0.297,P＜0.01)。护理管理者在临床工作中可采取积极有效的措施塑造关怀型伦理气氛,避免或削弱功利型伦理气氛的形成, 从而降低道德困境的发生。

     

国外护士道德韧性的研究进展及启示

结合既往资料,对国外护士道德韧性的概念发展、特征、测量工具、影响因素、作用进行具体综述。道德韧性的6个特征包括个人正直、关系正直、适应力、自我调节、自我管理、道德效能。护士道德韧性的影响因素包括性别、年龄、协调联系、同伴支持、道德困扰和道德勇气。研究发现道德韧性可以作为抵抗道德困境的途径、提高护士心理健康水平,以及减少职业倦怠与降低离职率。总结提出宏观层面应制定政策、提供组织支持,中观层面培养道德韧性,微观层面指出我国护士道德韧性的研究发展方向,为国内护士道德韧性的发展提供参考。

     

试析社区护士角色道德

角色道德是由角色产生、发展而形成的一种心理结构。社区护士的角色道德问题表现为角色不清、缺乏角色转换的心理准备,原因在于社区护士的形象模糊、制度建设不完善以及缺乏提升自我素质和境界的环境。建议以道德文化为切入点推进角色道德建设,以角色道德价值观教育为核心,构建适合社区护士的角色道德规范。     

道德与美德辨析

功利与道义、责任与义务、规范与自由、必须与应该、他律与自律等等,一直是伦理学难以达成共识的根本性问题,追溯其根源,却缘于道德与美德相混淆。因而,辨析道德与美德而使之各归本位,这是推进伦理学前进的认知前提。客观论之,道德属于他律,是人人必须遵守的社会规范,所以,道德是功利的,它以自我利益持守为出发点,以权利与责任对等为基本原则,以实现个人利益为直接目的。道德是美德的基础,因而,美德属于自律,是对道德的卓越,是人人应该响应的社会倡导,所以,美德是道义的,它以自我利益放弃或超越为起步,以无私利他为基本准则,以履行责任之外的义务来增进他者利益为展开方式,以实现个性张扬和精神自由为直接目的。     

区域美德与道德资源建设——以山东省聊城市改革开放以来的道德模范人物为例

改革开放以来,山东省聊城市产生了以孔繁森、张海迪、季羡林、徐本禹、白云等为代表的一大批在全省、全国具有重要影响的道德人物,直接促进了山东省乃至全国的道德建设。他们崇高道德品质的形成既有传统地域文化的影响,也有时代精神的呼唤,还有自身的人生磨练,更离不开成长过程中党和组织的培养。重视区域性道德模范人物的发掘和总结,加强对区域性道德模范人物的道德品质的研究,赋予其新的时代内涵,强化地方政府的投入和引导是将区域美德转化为有效道德资源的途径。     

分布式道德机制：人工智能体道德建模的新策略

人工智能体道德建模的目的是让它们在道德实践中与人类和其他智能体更好地相处。目前主要有四种建模策略：隐式、自上而下式、自下而上式和混合式。但是这些策略存在技术层面的困境,如设计范式、道德转译和算法黑箱等问题,并且在社会层面上也难以应对伦理对齐的困境。这是因为现行策略认为人工智能体在道德实践中发挥着线性作用,能够独立实现某种外在的道德规范,从而将人工智能体从实践中隔离出来。采用分布式道德机制来实现人工智能体道德建模,将人工智能体置于多智能体系统中,可以在人与人工智能体的交互式道德实践中形成开放、包容的道德规范和分配式道德责任。这种机制不仅能够消解现行策略的困境,还能够促进人工智能体与人类之间形成道德共生关系。     

美德与报偿——亚当·斯密道德报偿理论及其意义

在亚当·斯密的伦理学中,基于合宜性的报偿,是其道德论证的重要主题.在他看来,美德总会得到报偿,而报偿也最能鼓励和促进美德的发扬光大,因而美德与报偿的情感及社会机制,不仅涉及个体德性与幸福的实现,也成为构建公正与良序社会的重要实现方式.诠释其报偿理论的伦理内涵,对于当下伦理秩序与和谐社会建构具有重要的启示性意义.     

Moral Courage and Facing Others

Abstract

Moral courage involves acting in the service of one’s convictions, in spite of the risk of retaliation or punishment. I suggest that moral courage also involves a capacity to face others as moral agents, and thus in a manner that does not objectify them. A moral stand can only be taken toward another moral agent. Often, we find ourselves unable to face others in this way, because to do so is frightening, or because we are consumed by blinding anger. But without facing others as moral subjects, we risk moral cowardice on the one hand and moral fanaticism on the other.     

Blended courage: Moral and psychological courage elements in mental health treatment seeking by active duty military personnel

We propose that seeking mental health care in an environment with heightened stigma may combine elements of both psychological and moral courage. Interviews of 32 active duty US Army personnel about their process of seeking current mental health care were analyzed for themes of voluntary action, personal risk, and noble or worthwhile goals (benefits). Risks and benefits were divided into internal risks and benefits, characteristic of psychological courage; and external risks and benefits, characteristic of moral courage. Concerns about external risks were themes in all narratives, while concerns about internal risks were themes in only about half of narratives. Both internal and external benefits of treatment were themes in approximately three-quarters of the narratives, whereas doubts about internal (but not external) benefits were also expressed at a similar rate. Thus, participants described an act of blended courage, with social risks of moral courage taken for wellness goals of psychological courage.     

The Idea of Moral Progress

This paper shows that moral progress is a substantive and plausible idea. Moral progress in belief involves deepening our grasp of existing moral concepts, while moral progress in practices involves realizing deepened moral understandings in behavior or social institutions. Moral insights could not be assimilated or widely disseminated if they involved devising and applying totally new moral concepts. Thus, it is argued, moral failures of past societies cannot be explained by appeal to ignorance of new moral ideas, but must be understood as resulting from refusals to subject social practices to critical scrutiny. Moral philosophy is not the main vehicle for disseminating morally progressive insights, though it has an important role in processes that lead to moral progress. Yet we have grounds for cautious optimism, since progressive moral insights can be disseminated and can, sometimes, have constructive social effects.     

模糊道德事件中权威对儿童道德推理影响的研究

研究使用模糊道德事件来研究儿童权威概念对其道德判断的影响,并初步探讨了权威的个人特征对儿童的道德判断的影响.结果表明,使用模糊道德事件的研究材料能诱发儿童根据故事情境中的权威观点来进行判断;模糊道德事件判断结果表明儿童的独立道德判断立场会因为较高级别权威(校长和教师)的相反观点而改变,但很少会因为低权威或无权威者(班长与普通同学)的相反观点而改变.     

The Failed Courage of the Fanatic

Fanatic acts are carried out by those who regard their inner being as having to be denied. By means of a projective identification to a leader and a strident religious cause, they experience their unworthy and evil self as having to be sacrificed so that their good self—as projected on the leader and the cause—can survive and reign. True prophets, as contrasted with the leaders of fanatic groups, do not teach their disciples to hate and flee those who oppose them; but, instead, to build a better world by coming caringly together with their adversaries to heal the wounds of loneliness, shame, and self-hatred.     

解释水平视角下的道德判断

道德判断对社会合作有重要意义。近20年来涌现出大量对道德判断的研究。经典的社会直觉模型和双加工模型已经不足以解释所有的研究发现。近年来,解释水平理论为道德判断的研究提供了一个新的视角。通过文献梳理发现,基于解释水平理论的道德判断研究可以分为两难的道德判断研究和一般的道德判断研究。两难的道德判断研究已经有了较为一致的结论,但是一般的道德判断研究还存在争议。解释水平影响道德判断的深层原因可能是通过关注点影响道德判断的标准。未来的研究可以着眼于跨文化研究和深层机制的剖析,为解释水平视角下的道德判断研究提供更多的实验证据,加深人们对道德判断的理解。