Moral Reasoning and its Implications for Pharmacy Education
Keywords:
Moral reasoning, Pharmacy education, Patient-focused care, EthicsAbstract
A major goal of schools of pharmacy is to graduate well- trained pharmacists who possess both the requisite technical skills needed to be competent pharmacists and who are able and willing to provide patient-focused care. Doing so benefits pharmacy’s major stakeholders: the institution, the pharmacy organization, the patient and society. Moral reasoning is grounded in the cognitive moral development field and attempts to explain the human decision-making process prior to behavior. Why is training in moral reasoning important for pharmacy students? It is important because students at higher levels of moral development may demonstrate an increased probability of adhering to a higher level of patient-focused care. This paper discusses and answers the following questions:
1. What is moral reasoning?
2. Why is training in moral reasoning important to pharmacy
education and can it be measured?
3. How is moral reasoning related to clinical decision-making?
4. How can moral reasoning be fostered in pharmacy students?
References
Armstrong, M. (1993) “Ethics and professionalism in accounting education: A sample course”, Journal of Accounting Education 11, 77–92.
Clyne, K.E., Gray, D.R. and Veatch, R.M. (1991) “Responding to a physicians request to mislabel a patient’s prescription”, American Journal of Pharmaceutical Education 48, 296–300.
Elstein, A.A. and Lindenfeld, R. (1979) “A compendium of performance evaluation instruments for health professions education”, Office of Medical Education and Research (Michigan State University, East Lansing, MI), pp. 1–74.
Grover, S.L. (1993) “Why professionals lie: The impact of professional role conflict on reporting accuracy”, Organi- zational Behavior and Human Decision Processes 55, 251–272.
Haddad, A.M. (1991) “Ethical problems in pharmacy practice”, American Journal of Pharmacy Education 50, 1–6.
Kerr, S. (1975) “On the folly of rewarding A while hoping for B”, Academy of Management Journal 18, 769.
Kohlberg, L. (1969) “Stage and sequence: The cognitive-develop- mental approach to socialization”, In: Goslin, D.A., ed, Handbook of Socialization Theory and Research (Rand McNally, Chicago).
Krichbaum, K., Rowan, M., Duckett, L., Ryden, M. and Savik, K. (1994) “The clinical evaluation tool: A measure of the quality of clinical performance nursing of baccalaureate students”, Journal of Nursing Education 33, 395–404.
Latif, D.A. (2000) “The relationship between ethical dilemma discussion and moral development”, American Journal of Pharmaceutical Education 64, 126–133.
Latif, D.A. (2002) “An assessment of the moral development of American and Canadian Pharmacy Students”, International Journal of Pharmacy Practice 10, 153–160.
Latif, D.A., Berger, B.A., Harris, S.G., Barker, K.N., Felkey, B.G. and Pearson, R.E. (1998) “The relationship between community pharmacists’ moral reasoning and components of clinical performance”, Journal of Social and Administrative Pharmacy 15, 210 – 224.
Leming, J.S. (1978) “Cheating behavior, situational influence and moral development”, Educational Research 71, 214–217.
McNeel, S. (1994) “College teaching and student moral develop- ment”, In: Narvaez, D. and Rest, J.R., eds, Moral Development in the Professions: Psychology and Applied Ethics (Lawrence Erlbaum Associates, Hillsdale, NJ).
Oser, F. (1986) “Moral education and values education: The discourse perspective”, In: Wittrock, M.C., eds, Handbook of Research on Teaching (Macmillan, New York, NY).
Penn, W.Y. (1990) “Teaching ethics—A direct approach”, Journal of Moral Education 19, 124–138.
Power, C., Higgins, A. and Kohlberg, L. (1989) Lawrence Kohlberg’s Approach to Moral Education (Columbia University Press, New York).
Rest, J.R. (1979) Developments in Judging Moral Issues (University of Minnesota Press, Minneapolis).
Rest, J.R. (1986) Moral Development: Advances in Research and Theory (Praeger, New York).
Rest, J.R. (1990) Revised Manual for the Defining Issues Test (University of Minnesota Press, Minneapolis).
Rest, J.R. (1994) “Background: Theory and research”, In: Narvaez, D. and Rest, J.R., eds, Moral Development in the Professions: Psychology and Applied Ethics (Lawrence Erlbaum Associates, Hillsdale, NJ).
Self, D.J. and Olivarez, M. (1993) “The influence of gender on conflicts of interest in the allocation of limited critical care resources: Justice versus care”, Journal of Critical Care 8, 64 – 74.
Self, D.J., Baldwin, D.C. and Wolinsky, F.D. (1992) “Evaluation of teaching medical ethics by an assessment of moral reasoning”, Medical Education 26, 178–184.
Self, D.J., Olivarez, M. and Baldwin, D.C. (1998) “The amount of small-group case-study discussion needed to improve moral reasoning skills of medical students”, Academic Medicine 73, 521 – 523.
Sheehan, T.J., Husted, S.D., Candee, D., Cook, C.D. and Bargen, M. (1980) “Moral judgment as a predictor of clinical perform- ance”, Evaluation of Health Professions 8, 379–400.
Sisola, S.W., Principled Moral Reasoning as a Predictor of Clinical Performance in Physical Therapy Doctoral dissertationUni-
