• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.268-284
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• 1995

This study was designed to test effects of nursing ethics education (NEE) on moral reasoning and ethical decision making of subjects. This NEE that was teached for 10 hours course was composed of these : Nurses' ethical code, moral responsibility, Moral value and professional accountability, Respect for human life, General ethics, Theory and Norms of biomedical ethics, Ethical decision making model and Discussion about hypothetical ethical dilemmas Twenty-five senior student nurses were sampled from four year college of nursing from Nov. 3rd, 1993 to Nov. 24th, 1993. Data were collected through self-reported questionnaires included two kinds of tests. Rest's Defining Issues Test was adopted to measure the stage of moral development, which was classified with the stage 2 (instrumental relativist orientation), the stage 3 (interpersonal concordance), the stage 4 (law and order), the stage 5A (societal consensus), and the stage 5B (intuitional humanism), the stage 6 (universal ethical practice). In particular, the level of principled thinking (P) was measured by summing these scores of the stages 5A, 5B, and 6. The possible range of P is 0 to 95. As for measuring the levels of morality and nursing dilemma, Crisham's Nursing Dilemma Test was adopted. This test generated the morality score(MS) and the dilemma score (DS). The data were analyzed by t-test, ANOVA, Kruskal-Wallis test, Mc Nemar's test and Pearson correlation coefficients. The results were as follows ; 1. For the Moral Reasoning both before and after NEE, The Mean score of the stage 5A was significantly higher than that of other stages.(P=0.0001) Before NEE, the mean score of the stage 4 was significantly different from stage 2, 3, 5A, and after NEE, different from stage 2, 5B,6. 2. The analysis of change of moral development level revealed that the score of stage 4 increased after NEE.(P=0.0004) 3. The Effect of NEE for the mean score of 5A, 6, P after education was significantly different by birth place. 4. With regard to the five dilemmas postulated such as forcing medication performing cardiac pulmonary resuscitation, reporting a medication error, informing diagnosis to terminally ill adult, and providing new-nurse orientation, the mean score of the MS and the DS was no significant difference with general characteristics of the students. Effect of NEE morality score and dilemma score after education was no significant difference. 5. As for the correlations between moral reasoning and decision making, the score of the stage 2, 5A, 6, DS was positively correlated with the scores of before and after. Positive correlation was also observed between the scores of stage 2 and stage 4, stage 3 and 6. On the other hand, the score of P was negatively correlated with the scores of stage 2 and of stage 4 and of stage 5A. The score of the stage 5A was also negatively correlated with the score of the sge 6.

• Journal of the Korean Home Economics Association
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• v.45 no.3
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• pp.71-86
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• 2007

The purpose of this study was to investigate North Korean child defectors and South Korean children's pro-social moral reasoning, pro-social decision-making, moral reasoning and moral judgement on violence. The participants were 82 North Korean child defectors and 186 South Korean children in Seoul and Kyunggi Province. All respondents answered self-report questionnaires including 6 stories of pro-social moral conflicts and 4 stories of moral conflicts on violence. Data were analyzed by independent sample t-test, $Scheff{\acute{e}}$ test, repeated measure ANOVA and one-way ANOVA. The major findings were as follows. First, North Korean child defectors showed a bigger difference between the level of pro-social moral reasoning in close relationship situations and that in distant relationship situations than South Korean children did. In the 11-13 year old group, North Korean child defectors showed lower level of pro-social moral reasoning than that of South Korean children. Second, children showed more helping responses in close relationship situations than in distant relationship situations. The 11-13 year old group Children also showed more helping responses than the 14-16 year old group did. Third, 11-13 year old South Korean children showed a higher level of moral reasoning on violence than the North Korean child defectors did. Finally, North Korean child defectors judged violence with a justifiable intention as being more wrong than South Korean children did.

• Korean Journal of Culture and Social Issue
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• v.23 no.4
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• pp.557-585
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• 2017

In this research, it was examined whether predicting the ripple effects of events influences decision-making difficulty. In addition, it was examined whether perceived accountability for decision-making results mediates the relation above. In Study 1, participants were presented with policy decision-making vignettes and were asked to report on the ripple effects of their policy decisions as well as on the difficulty of making the decision. Consistent with the hypothesis, the bigger the expected ripple effects, the greater difficulty participants felt in making policy decisions. In Study 2, ripple effect magnitudes were experimentally manipulated such that participants were led to predict big ripple effects in one condition and relatively small ripple effects in another condition. It was investigated whether participants predicting bigger ripple effects would perceive decision-making to be more difficult than participants predicting smaller ripple effects. Whether this relation would be mediated by perceived personal accountability for the results of decision-making was also examined. Consistent with expectations, it was found that in the moral domains of Harm/care, Fairness/reciprocity, and Ingroup/loyalty, participants predicting bigger ripple effects reported more difficult decision-making than their counterparts. The relation above was mediated by perceived personal accountability for decision-making results only in the domain of Ingroup/loyalty. In combination, these results showed that bigger predicted ripple effects contributed to greater decision-making difficulty. In addition, participants felt more responsible for the results of their decisions when predicting bigger ripple effects, which led them to feel greater decision-making difficulty in the domain of Ingroup/loyalty. The implications of these results and future directions for research are discussed.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.1
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• pp.5-21
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• 1995

This study purports to investigate moral reasoning and ethical decision making among student nurses in the hypothetical moral dilemmas. The subjects consisted of 25 senior nursing students attending at a four-year college. Data were collected through self-reported questionnaires in November, 1993. The questionnaires included two kinds of tests. Rest's Defining Issues Test was adopted to measure the stage of moral development, which was classified with the stage 2 (instrumental relativist orientation), the stage 3 (interpersonal concordance), the stage 4 (law and order), the stage 5A (societal consensus), and the stage 5B (intuitional humanism). In particular, the level of principled thinking (P) was measured by summing those scores of the stages 5A, 5B, and 6. The possible range of P is 0 to 95. As for measuring the levels of morality and nursing dilemma, Crisham's Nursing Dilemma Test was adopted. This test generated the morality score(MS) and the dilemma score (DS). The data were analyzed by t-test, ANOVA, Kruskal-Wallis test, and Pearson correlation coefficients. The findings are following. 1. The mean score of P was 52.93 (SD=12.82). The mean score of the stage 5A was significantly higher than the scores of other stages (17.92, p=.0001). 2. The mean score of P was not significantly different by general characteristics of the students. Of the scores of each stage, only the mean score of the stage 3 revealed significant difference by the status of living with parents(p=.0283). The score was highest when "living with both parents"(15.22), which was followed by "living with no parents"(10.0), "living with father only"(9.0), and "living with mother only"(7.50). 3. With regard to the five dilemmas postulated such as forcing medication, performing cardiac pulmonary resuscitation, reporting a medication error, informing diagnosis to terminally ill adult, and providing new-nurse orientation, most students perceived them as moral dilemma rather than nonmoral one. Most students made a positive decision according to moral reasoning in the above situations except for providing new-nurse orientation. 4. The mean score of the MS was 3.30 and that of the DS was 3.32. These scores did not show significant difference with general characteristics of the students. 5. As for the correlations between moral reasoning and decision making, the score of the stage 5A was positively correlated with the scores of P(.74, p<.0001) and DS(.56, p<.001). Positive correlation was also observed between the scores of stage 2 and stage 4(.68, p<.0001). On the other hand, the score of P was negatively correlated with the scores of stage 3(-.47, p<.05) and of stage 4(-.55, p<.001). The score of the stage 5A was also negatively correlated with the score of the stage 6(-.42, p<.05).

• Journal of The Korean Association For Science Education
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• v.29 no.2
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• pp.253-266
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• 2009

This study was focused on analyzing students' informal reasoning patterns and their considerations in decision-making on socioscientific issues. This study involved 20 undergraduate students (10 biology majors and 10 non-biology majors) and showed how the two groups responded on socioscientific issues. Semi-structured interviews were conducted twice respectively based on six scenarios of gene therapy and human cloning. The result showed 93% of the total number of participants' decisions were made by rationalistic reasoning, whereas emotional reasoning was 49%, and intuitive reasoning was 27%. Students usually used two or three informal reasoning patterns together. Most of the students took more consideration on social factors. Some perceived ethical and moral implications of the issues, but they did not consider them seriously. They made their decisions depending on their own values, etc. 65% of the participants got their information on socioscientific issues from the mass media. Biology majors hardly used intuitive reasoning compared to non-biology majors. The Biology major group took into deep considerations on socioscientific issues while the non-biology major group seemed to interpret the given scenarios simply. This implied that the content knowledge was a significant factor of their decision-making. Therefore, it is necessary to develop proper science courses for non-major students to improve their decision-making on socioscientific issues. So, when we develop educational materials or programs, we should consider students' reasoning patterns, their considerations in decision-making, and their content knowledge. And because the mass media has the potential to play a key role for an effective education, we need to make a plan to make a practical application.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.2
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• pp.176-184
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• 2020

Purpose: We explored emergency nurses' experiences of coping with moral distress. Methods: A qualitative research design was used. We conducted in-depth interviews with 11 nurses working at a regional emergency medical center in South Korea. Data were analyzed using conventional content analysis. Results: The main theme of nurses' coping with moral distress was "a passive emotion-based response." We also extracted three categories of coping strategies: "uncritical adaptation to anguished situation," "self-justification for not acting," and "flight from ethical decision making." Conclusion: Nurses coped with moral distress in a passive and emotional way, possibly because of perceived incompetence and compliance to an organizational hierarchy. The findings imply that effective approaches to addressing moral distress in emergency nurses are needed at the individual and organizational levels.

• Journal of Korean Dental Hygiene Science
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• v.6 no.2
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• pp.91-100
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• 2023

Background: This study evaluated the learning outcomes of dental hygiene students' ethical consciousness and ethical decision-making competence through dental ethics courses conducted in some universities. Methods: The subjects were 35 and 29 fourth-year dental hygiene students at G University in the first semester of 2021 and 2022, respectively, and 53 and 43 third-year dental hygiene students at D University, respectively, for a total of 160 students. After implementing the dental hygiene ethics course, classroom performance was evaluated in terms of moral sensitivity, confidence in making ethical decisions, classroom practicality, learning outcomes, and class satisfaction. Statistical analysis was conducted using independent t-test and paired t-test, and the statistical significance level was 0.05. Results: Both universities reported an increase in moral sensitivity and confidence in ethical decision-making after the course (p<0.001). Classroom practicality and class satisfaction for the dental hygiene ethics course did not differ between disciplines and were rated positively with a score of 4 or higher (p>0.05). Learning outcomes were higher among 4-year students than 3-year students (p<0.001). Conclusions: It was evaluated that the ethics in dental hygiene curriculum can strengthen students' competence in ethical decision-making, including moral sensitivity and confidence in solving ethical problems in dental hygiene.

• The Journal of Korean Philosophical History
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• no.25
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• pp.99-135
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• 2009

This study is to investigate many kinds of conceptual models of social problem solving approach as well as decision making method, and then describes educational implications, especially for more effective method of teaching problem solving ability in order to reduce children' anti social behaviors and to be able to have their healthy and happy lives. Problem solving ability or decision making skills have been taken to goal of primary school curriculum, but is too cognitive or too centered to morality for student to get that kinds of skill or competency. As a result of new education method is developed on the basis of Socal Emotional Learning(SEL) as well as Emotional Intelligence which put on the importance on the role of emotion in the problem solving. This method have two distinctions. First, It has the background of culture specific views of emotion to be proper this method in our society. Second, It should be integrated into moral education as a part of school curriculum to establish secure and long term intervention.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.239-274
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• 2010

Advance directive refers to a description of the treatment method a patient wants to be provided with in case where the person is unconscious or lacks an ability to decision making in a future period or a declaration of intention that delegates and appoints another person who makes a decision regarding a treatment method on behalf of the person. Advance directive is usually a document form, but oral statement is acceptable as well. Advance directive may have a variety of forms though, it basically consists of two basic forms. That is, one is a living will, and the other is a surrogate decision making. Though the importance of advance directive has been emphasized, and the necessity of adopting the system has been strongly argued for so far, the debates on criteria, method, and procedure alike have not yet reached an agreement. It is because even the concept of advance directive is more or less ambiguous, and each specific method has its own theoretical limitations and practical constraints. Thus the inquiries on advance directive raised in the study are summarized as the meaning, practicability, and philosophical foundation of the advance directive. Firstly, the theoretical limitations of Advance directive may be categorized into conceptual and moral limitations. In case of conceptual limitations, authors of advance directives may not be well aware, in advance, of the particular situation in which he or her will experience in the future, and patients may experience the change in his or her values and lack the understanding and information about the future situation due to the changes in treatment methods. In case of moral limitations, a patient has a limited moral autonomy right and self identity that have an impact on his or her preference. Secondly, in case of practical constraints for advance directive, there exist cultural features, low ratio of documentation, as patients themselves admit, and low predictability and stability of patient's own preference regarding life-sustaining care. And the problem of validity and accuracy in proxy's decision making is also raised. Those who administer a living will, especially, may have a difficulty in understanding the directive by a patient, so that the accuracy of execution cannot be secured. In the sense, it is needed to implement a legal device in order to solve such problems. In summary, it is urgently required to understand the limitations and explore desired alternatives to overcome the relevant problems in advance, which must contribute to successfully adopting and effectively operating the advance directive system in Korea.

• Journal of Home Health Care Nursing
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• v.30 no.2
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• pp.163-173
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• 2023

Purpose: The aim of this descriptive research study was to identify the factors affecting the ethical decision-making of nursing students. Methods: A convenience sample of 193 nursing students from three nursing colleges in D city who were engaged in clinical practice completed an online Google Forms questionnaire from September 9 to September 20, 2021. Using SPSS 23.0, data were analyzed with descriptive statistics, an independent t-test, a one-way ANOVA, Scheffé's test, Pearson's correlation coefficient, and a multiple regression analysis. Results: The influencing factors of ideal ethical decision-making were guilt (β=.38, p<.001), awareness of the nurses' Code of Ethics (β=.18, p=.023) and motivation for entering school, among general characteristics (β=-.18, p=.033). The explanatory power of the model was 22.2%. Further, the influencing factors of realistic ethical decision-making were ideal ethical decision-making (β=.26, p=.001) and grade (among general characteristics) (β=.15, p=.029); the explanatory power of the model was 17.9%. Conclusion: Various educational tools and programs pertaining to making ideal and ethical decisions must be enhanced to promote ethical choices in clinical areas and realistic ethical decision-making ability to actually make such choices. This focus may enable nurses to improve their nursing professionalism in the future.