Developing Moral Maturity

by Mark Hughes, MD, MA

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    00:00 Which then brings us to the idea of, you know, our own moral compass.

    00:05 So we've talked about, you know, we all have our own cultural background that we come from, that we'd learned from childhood onward.

    00:14 Those innate and culturally constructed systems that generally help us to manage moral challenges.

    00:19 So, you know, finding our true north of how we should handle a situation.

    00:25 And that's generally been developed in a broader wisdom, you know, there may be a tradition of values, principles, codes, practices that we learned from our parents, from our family members, from our larger culture, might be religious tradition or other things that have sort of said "This is how you should behave in a particular circumstance." And that moral compass is going to be reflected in the character, you know, our personality that we develop over time.

    00:55 It will matter in terms of our decision-making so it might be our, you know, first way to approach a situation is this is how I would make a decision based on my own morality that I've learned from childhood onward.

    01:08 It also means that it gives us agency, you know, being a moral agent to make these decisions, do these actions, how we behave in general.

    01:19 It also might mean that there is responsibility, you know, so whatever we said as our moral compass, we have a responsibility to try to adhere to that.

    01:28 And then it influences our relationships.

    01:30 So, whether that's in our personal realm with our intimates and, you know, our friends and family, how we interact with them in terms of good and bad, right and wrong actions, what we should or should not do in maintaining those relationships, but it also means for the healthcare professional when they're in relationship with a patient or the patient's family or both that they use their moral compass to help guide their actions.

    01:58 Which then brings us to the idea of moral development.

    02:02 So, there are 4 stages of moral development or becoming morally mature.

    02:08 The first is going to be moral sensitivity, which might be informed by your moral compass, but it's this idea that you recognize there's an ethical dilemma.

    02:17 So you see that there is a problem, you know, there is these 2 conflicting approaches or assumptions and you know that they exist and how to figure out a way to reconcile them.

    02:31 In the medical realm, you know, when we're taking care of patients, moral sensitivity first starts when we recognize the suffering of another person.

    02:40 So once we become aware of their suffering, that generates in us a feeling of empathy towards them and wanting to help them through their suffering.

    02:49 So that in in of itself just the fact of illness and the suffering that it entails creates a dilemma, you know.

    02:57 We want to try to help them, we need to figure out a way to do that, we empathize with their condition, we have the moral sensitivity to then say "Okay, I must act to take care of them." We then have to discern well how we're going to act and so that requires moral judgment.

    03:15 We first of all have to identify and weigh all of the relevant aspects of the situation.

    03:21 What is morally relevant in this circumstance in terms of, you know, do we apply principles, do we apply virtue theory, do we think about the ethic of care? All those may be morally relevant to handling this particular dilemma.

    03:35 We think through it, try to identify all possible solutions, you know, just as a clinician creates a differential diagnosis when they're thinking about, you know, a symptom complex.

    03:46 And you know what could the person have as their diagnosis, we think of all the list of possible diagnoses.

    03:53 The same thing here when we're doing moral judgment we have to think of all the possible solutions.

    04:00 Based on, you know, using our, you know, structured approach when we're doing the systematic approach, we're then going to say "Well, there's one preferable action that we grounded in ethical theories and principles, all these approaches that we've talked about with ethics." This is the ethically appropriate action.

    04:20 We should do this one as opposed to any of the other possible solutions.

    04:26 You then need to have moral motivation.

    04:28 So if you're going to be morally mature, you have to be motivated to then do the action that you think is the right action.

    04:34 Not just identifying the right action, but actually following through on it.

    04:40 So, a moral agent will make a decision to act, you know, despite the consequences.

    04:44 So even sometimes when the right action may have bad consequences for yourself, maybe repercussions in terms of your behavior.

    04:52 But if you think it's the right thing to do, you have to have the moral courage, the motivation to follow through on that action.

    05:01 And if you don't, if you are, you know, mired in in action, if you leave that problem unresolved, that's going to create moral distress.

    05:14 You're going to feel the emotional reaction of not doing the right thing.

    05:19 So then the last aspect of being morally mature is that you follow through with moral action.

    05:24 So you implement the course of action in line with your commitments whether those are, you know, from things you learned from your moral compass, from your cultural background.

    05:33 If it's things that you've learned from your profession, the professional codes and guidelines that have been instilled in you as you develop professionally, whatever those commitments are that you implement, that course of action.

    05:46 The core goal of all that is to maintain your moral integrity.

    05:51 So being whole as a person so that you can then be there, you know, for the next dilemma or the next patient that you have the perseverance to follow through on the action, recognize, you know, similar to with the ethic of care that that has effects on your relationships and you want to maintain the trust that the patient has on you so you have to maintain your integrity to adhere to the trust that the patient has placed in you that you will do the right things for them.

    About the Lecture

    The lecture Developing Moral Maturity by Mark Hughes, MD, MA is from the course Introduction to Clinical Ethics.

    Included Quiz Questions

    1. Decision-making
    2. Genetics
    3. Sleep patterns
    4. Hair color
    5. Taste
    1. Moral sensitivity
    2. Moral realism
    3. Moral pain
    4. Moral growth
    5. Moral division
    1. Implementing a course of action in line with moral commitments
    2. Identifying the morally relevant aspects of a dilemma
    3. Identifying the ethically responsible decision
    4. Recognizing that an ethical dilemma exists
    5. Weighing the morally relevant aspects

    Author of lecture Developing Moral Maturity

     Mark Hughes, MD, MA

    Mark Hughes, MD, MA

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