Moral reasoning and behavior of striking physicians in Israel

A last resort? A scoping review of patient and healthcare worker attitudes toward strike action

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context-dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction.

Hypothetical versus real-life moral reasoning among psychopathic and delinquent youth

Differences in moral reasoning concerning hypothetical versus real-life conflicts were examined with a sample of 44 youths (aged 15–18 years) who were classified as psychopathic, delinquent, or normal. All subjects were individually interviewed and assessed on (a) Hare's Psychopathy Checklist, (b) two of Kohlberg's hypothetical moral dilemmas, and (c) a subject-generated real-life moral dilemma. The results revealed that the normal youths attained a higher level of moral reasoning than either the delinquents or psychopaths. All groups scored lower on the real-life than the hypothetical dilemmas, indicating that hypothetical dilemmas may best elicit a person's level of moral reasoning competence, whereas real-life dilemmas may entail factors that lower the level of reasoning used in a situation of moral conflict. These two dilemma types also were found to elicit differing moral orientations. Finally, psychopaths were found to orient more to egoistic concerns than did delinquents when discussing real-life dilemmas.

Toward a more pragmatic approach to morality: a critical evaluation of Kohlberg's model

In this article, the authors evaluate L. Kohlberg's (1984) cognitive- developmental approach to morality, find it wanting, and introduce a more pragmatic approach. They review research designed to evaluate Kohlberg's model, describe how they revised the model to accommodate discrepant findings, and explain why they concluded that it is poorly equipped to account for the ways in which people make moral decisions in their everyday lives. The authors outline in 11 propositions a framework for a new approach that is more attentive to the purposes that people use morality to achieve. People make moral judgments and engage in moral behaviors to induce themselves and others to uphold systems of cooperative exchange that help them achieve their goals and advance their interests.