Hostname: page-component-7c8c6479df-ph5wq Total loading time: 0 Render date: 2024-03-27T11:28:14.828Z Has data issue: false hasContentIssue false

Measurement of Moral Development in Medicine

Published online by Cambridge University Press:  29 July 2009

Donnie J. Self
Affiliation:
A professor in the Departments of Humanities in Medicine, Pediatrics, and Philosophy, College of Medicine, Texas A&M University, College Station.
Evi Davenport
Affiliation:
Is Director of Learning Resources in the School of Allied Health Sciences/School of Nursing, University of Texas Medical Branch, Galveston.

Extract

The past two decades have been a time of heightened interest in the moral aspects of the practice of medicine. This interest has been reflected in medical education by the establishment of medical humanities programs in both preclinical and clinical education in many medical schools. It has also been reflected in the literature with a dramatic increase in journal articles on medical ethics as well as the development of medical ethics in textbooks. A number of journals have developed that are specifically devoted to medical ethics, including The Journal of Medical Ethics, The Journal of Medicine and Philosophy, The Journal of Medical Humanities, Theoretical Medicine, Cambridge Quarterly of Healthcare Ethics, just to name a few. The literature includes both theoretical foundations and conceptual analyses of particular issues as well as practical advice and general suggestions for how to implement programs in medical humanities.

Type
Articles
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. ED, Pellegrino, McElhinney, TK. Teaching Ethics, the Humanities, and Human Values in Medical Schools: A Ten-Year Overview. Washington DC: Society for Health and Human Values, 1982.Google Scholar

2. McElhinney, TK. Human Values Teaching Programs for Health Professionals. Ardmore, Pennsylvania: Whitmore Publishing Company, 1981.Google Scholar

3. Bickel, J. Integrating Human Values Teaching Programs Into Medical Students' Clinical Education. Washington, DC: Association of American Medical Colleges, 1986.Google Scholar

4. JI, Bouford, Carson, RA. [Project Directors]. The Teaching of Humanities and Human Values in Primary Care Residency Training. McLean, Virginia: Society for Health and Human Values, 1984.Google Scholar

5. Childress, JF. Who shall live when not all can live? Soundings 1970;53:339–55.Google Scholar

6. RS, Duff, Campbell, AGM. Moral and ethical dilemmas in the special care nursery. The New England Journal of Medicine 1973;289:890–4.Google Scholar

7. Siegler, M. Confidentiality in medicine—a decrepit concept. New England Journal of Medicine 1982;307:518–21.CrossRefGoogle ScholarPubMed

8. [Anonymous]. It's over Debbie. Journal of the American Medical Association 1988;259:272.CrossRefGoogle Scholar

9. TL, Beauchamp, Childress, JF. Principles of Biomedical Ethics. New York: Oxford University Press, 1983.Google Scholar

10. Brody, H. Ethical Decisions in Medicine. Boston: Little, Brown and Company, 1981.Google Scholar

11. Munson, R. Intervention and Reflection: Basic Issues in Medical Ethics. Belmont, California: Wadsworth Publishing Company, 1992.Google Scholar

12. Veatch, RM. Medical Ethics. Boston: Jones and Bartlett, 1989.Google ScholarPubMed

13. Self, DJ. The pedagogy of two different approaches to humanistic medical education: cognitive vs. affective. Theoretical Medicine 1988;9:227–36.CrossRefGoogle ScholarPubMed

14. Rachels, J. Active and passive euthanasia. New England Journal of Medicine 1975;292:7880.CrossRefGoogle ScholarPubMed

15. Thompson, JJ. A defense of abortion. Philosophy and Public Affairs 1971;1:4766.Google Scholar

16. Fletcher, J. Indicators of humanhood: a tentative profile of man. Hastings Center Report 1972;2:14.CrossRefGoogle Scholar

17. Callahan, D. The WHO definition of “health.” Hastings Center Studies 1973;1:7787.CrossRefGoogle ScholarPubMed

18. DJ, Self, Lyon-Loftus, GT. A model for teaching ethics in a family practice residency. Journal of Family Practice 1983;16:355–9.Google Scholar

19. Keller, AH. Ethics/human values education in the family practice residency. Journal of Medical Education 1977;52:107–16.Google ScholarPubMed

20. CM, Culver, Clouser, KD, Gert, B, et al. . Basic curricular goals in medical ethics. New England Journal of Medicine 1985;312:253–6.Google Scholar

21. KR, Howe, Jones, MS. Techniques for evaluating student performance in a pre-clinical medical ethics course. Journal of Medical Education 1984;59:530–2.Google Scholar

22. ED, Pellegrino, Thomasma, DC. A Philosophical Basis of Medical Practice. New York: Oxford University Press, 1981:3342.Google Scholar

23. Burns, CR, Ed. Legacies in Ethics and Medicine. New York: Science History Publications, 1977:1326.Google Scholar

24. SJ, Reiser, Dyck, AJ, Curran, WJ, Eds. Ethics in Medicine: Historical Perspectives and Contemporary Concerns. Cambridge, Massachusetts: The Massachusetts Institute of Technology, 1977:1679.Google Scholar

25. Bulger, RJ, Ed. In Search of the Modern Hippocrates. Iowa City, Iowa: University of Iowa Press, 1989:3256.Google Scholar

26. Pellegrino, ED. Humanism and the Physician. Knoxville, Tennessee: The University of Tennessee Press, 1979:3248.Google ScholarPubMed

27. Kohlberg, L. Essays on Moral Development: Volume 2, The Psychology of Moral Development. San Francisco: Harper & Row, 1984:640–51.Google Scholar

28. Piaget, J. The Moral Judgment of the Child [Trans Gabain, M] New York: Free Press, 1965 [1932].Google Scholar

29. Dewey, J. Moral Principles in Education. New York: Philosophical Library, 1954.Google Scholar

30. Kohlberg, L. Beds for bananas. The Menorah Journal 1948:385–99.Google Scholar

31. Snarey, JR. Cross-cultural university of social-moral development: a critical review of Kohlbergian research. Psychological Bulletin 1985;97:202–32.CrossRefGoogle Scholar

32. M, Nisan, Kohlberg, L. Universality and cross-cultural variation in moral development: a longitudinal and cross-sectional study in Turkey. Child Development 1982;53:865–76.Google Scholar

33. Kohlberg, L. Essays on Moral Development: Volume 1. The Philosophy of Moral Development. San Francisco: Harper & Row, 1981:1441.Google Scholar

34. Rawls, J. Justice as fairness: The Journal of Philosophy 1957;54:653–62.CrossRefGoogle Scholar

35. Rawls, J. A Theory of Justice. Cambridge, Massachusetts: Harvard University Press, 1971.Google Scholar

36. Gilligan, C. In a Different Voice: Psychological Theory and Women's Development. Cambridge, Massachusetts: Harvard University Press, 1982.Google Scholar

37. Noddings, N. Caring: A Feminine Approach to Ethics and Moral Education. Los Angeles: University of California Press, 1984:104–31.Google Scholar

38. Lyons, NP. Two perspectives: on self, relationships, and morality. Harvard Educational Review 1983;53:125–45.CrossRefGoogle Scholar

39. M, Blatt, Kohlberg, L. The effects of classrooms moral discussion upon children's level of moral judgment. Journal of Moral Education 1975;4:129–61.Google Scholar

40. A, Schlaefli, Rest, JR, Thoma, SJ. Does moral education improve moral judgment? A meta-analysis of intervention studies using the defining issues test. Review of Educational Research 1985;55:319–52.Google Scholar

41. Rest, JR. Can ethics be taught in professional schools? The psychological research. Ethics: Easier Said Than Done 1988;1:22–6.Google Scholar

42. SA, Goldman, Arbuthnot, J. Teaching medical ethics: the cognitive-developmental approach. Journal of Medical Ethics 1979;5:170–80.Google Scholar

43. TJ, Sheehan, Husted, SD, Candee, D. The Development of Moral Judgment Over Three Years in a Group of Medical Students. Paper presented at the American Educational Research Association Meeting, Los Angeles, 1981.Google Scholar

44. DC, Baldwin Jr, Daugherty, S, Self, DJ. Changes in moral reasoning during medical school. Academic Medicine 1991;66(Sep Suppl):13.Google Scholar

45. See note 36. Gilligan, . 1982.Google Scholar

46. C, Gilligan, Attanucci, J. Two moral orientations: gender differences and similarities. Merrill-Palmer Quarterly 1988;34:223237.Google Scholar

47. DJ, Self, Schrader, DE, Baldwin, DC Jr, Wolinsky, FD. A pilot study of the relationship of medical education and moral development. Academic Medicine 1991;66:629.Google Scholar

48. JF, Galaz-Fontes, Pacheco-Sanchez, ME, Sierra-Morales, I, Commons, ML, Gutheil, TG, Hausen, MJ. Medical School Training and Moral Reasoning in Mexico. Paper presented at the Fourth Adult Development Symposium Meeting,Cambridge, Massachusetts, 1989.Google Scholar

49. DJ, Self,Schrader, DE, Baldwin, DC Jr, Root, SK, Wolinsky, FD, Shadduck, JA. Study of the influence of veterinary medical education on the moral development of veterinary students. Journal of the American Veterinary Medical Association. 1991;198:782–7.Google Scholar

50. DJ, Self, Schrader, DE, Baldwin, DC Jr, Wolinsky, FD. The moral development of medical students: A pilot study of the possible influence of medical education. Medical Education 1993;27:2634.Google Scholar

51. See note 48. Galaz-Fontes, et al. 1989.Google Scholar

52. DJ, Self, Baldwin, DC Jr, Wolinksy, FD, Shadduck, JA. Further exploration of the relationship between veterinary medical education and moral development. Journal of Veterinary Medical Education 1993;20(3):140–7.Google Scholar

53. A, Colby, Kohlberg, L. The Measurement of Moral Judgment: Volume I. Theoretical Foundations and Research Validation. New York: Cambridge University Press, 1987:170.Google Scholar

54. Rest, JR. Moral Development: Advances in Research and Theory. New York: Praeger, 1986:2858.Google Scholar

55. DJ, Self, Baldwin, DC Jr, Wolinsky, FD. Evaluation of teaching medical ethics by an assessment of moral reasoning. Medical Education 1992;26:178–84.Google Scholar

56. DJ, Self, Wolinsky, FD, Baldwin, DC Jr. The effect of teaching medical ethics on medical students’ moral reasoning. Academic Medicine 1989;64:755–9.Google Scholar

57. DJ, Self, Baldwin, DC Jr, Olivarez, M. Teaching medical ethics to first-year students by using film discussion to develop their moral reasoning. Academic Medicine 1993;68(5):383–5.Google Scholar

58. See note 27. Kohlberg, . 1984:640–51.Google Scholar

59. JC, Gibbs, Widaman, KF. Social Intelligence: Measuring the Development of Sociomoral Reflection. Engle-wood Cliffs, New Jersey: Prentice-Hall, 1982:1271.Google Scholar

60. Rest, JR. Development in Judging Moral Issues. Minneapolis: University of Minnesota Press, 1979:3305.Google Scholar

61. RM, Martin, Shafto, M, Vandeinse, W. The reliability, validity, and design of the Defining Issues Test. Developmental Psychology 1977;13:460–8.Google Scholar

62. Rest, JR. Moral Development: Advances in Research and Theory. New York: Praeger, 1986:3305.Google Scholar

63. Self, DJ. Moral Reasoning as a Criterion for Resident Selection. Paper presented at the 18th Annual Spring Conference of the Society of Teachers of Family Medicine, Nashville, Tennessee, 1985.Google Scholar

64. DE, Benor, Notzer, N, Sheehan, TJ, et al. . Moral reasoning as a criterion for admission to medical school. Medical Education 1984;18:423–8.Google Scholar

65. See note 44. Baldwin, et al. 1991;66:13.Google Scholar

66. J, Sheehan, Husted, S, Candee, D, Cook, CD, Bargen, M. Moral judgment as a predictor of clinical performance. Evaluation and the Health Professions 1980;3:393404.Google Scholar

67. Kohlberg, L. The Uses and Abuses of Moral Stages: The Role of Stages in Understanding and Self-Understanding. Harvard University Center for Moral Education, 1973 [Unpublished Manuscript].Google Scholar

68. Self, DJ, Baldwin, DC Jr. Should moral reasoning serve as a criterion for medical student selection? Medical Education [Submitted].Google Scholar

69. Blasi, A, Bridging moral cognition and moral action: a critical review of the literature. Psychological Bulletin 1980;88:145.CrossRefGoogle Scholar

70. L, Kohlberg, Candee, D. The relationship of moral judgment to moral action. In: Kohlberg, L, Ed. Essays on Moral Development: Volume 2, The Psychology of Moral Development. San Francisco: Harper & Row, 1984:498581.Google Scholar