Professional ethics in pharmacy practice: developing a psychometric measure of moral reasoning

Background Practising pharmacists continuously develop their ethical reasoning skills, which evolve with practice experience and exposure to challenging scenarios. Considering the recent expansion of the roles of pharmacists and the paradigm shift in pharmacy practice, it is timely to explore community pharmacists' attitudes regarding the importance of ethics and their ethical reasoning. Objective To explore underlying factors influencing community pharmacists' and pharmacy students' ethical reasoning and attitudes towards pharmacy ethics, ethical reasoning processes and perceived current dilemmas. Setting Practising registered community pharmacists, pharmacists with provisional registration (interns) and final year pharmacy students in Australia. Method Two focus group discussions and two interviews were conducted with 16 Western Australian community pharmacists, interns and students. Participants were purposively selected for gender, background, practice setting, and practice experience. Main outcome measure Emerging themes embracing important influences on community pharmacists', interns' and students' ethical reasoning and perceived current ethical dilemmas and challenges. Results Two major themes embraced participants' ethical reasoning processes and conduct: (1) fundamental underpinning, from personal values and practice exposure, and (2) paradigm influenced, such as the changing healthcare landscape, expansion of roles, management of dilemmas, and competence. Increased frequency and complexity of ethical dilemmas related to role expansion. Rural pharmacists experienced unique ethical dilemmas in relation to practice isolation, privacy and confidentiality. Conclusion Changes in the community pharmacy practice environment has increasingly exposed pharmacists to more complex ethical dilemmas. Pharmacists practising in rural communities experience unique challenges. Structured and sound ethical reasoning skills are essential as pharmacists are faced with contemporary challenges.

Calls for the expansion of ethics education in the business and accounting curricula have resulted in a variety of interventions including additional material on ethical cases, the code of conduct, and the development of new courses devoted to ethical development [Lampe, J.: 1996]. The issue of whether ethics should be taught has been addressed by many authors [see for example: Hanson, K. O.: 1987; Huss, H. F. and D. M. Patterson: 1993; Jones, T. M.: 1988–1989; Kerr, D. S. and L. M. Smith: 1995; Loeb, S. E.: 1988; McDonald, G. M. and G. D. Donleavy: 1995]. The question addressed in this paper is not whether ethics should be taught but whether accounting students can reason more ethically after an intervention based on a discrete and dedicated course on accounting ethics. The findings in this paper indicate that a discrete intervention emphasising dilemma discussion has a positive and significant effect on students’ moral reasoning and development. The data collected from interviews suggest that the salient influences on moral judgement development include: learning theories of ethics particularly Kohlberg’s theory of cognitive moral reasoning and development; peer learning; and moral discourse. The implications from the findings in this study suggest that moral reasoning is responsive to particular types of ethics intervention and educators should carefully plan their attempts to foster moral judgement development.

Pharmaceutical activity is an integral component of the healthcare system, ensuring the provision of high-quality, effective, and safe medicines to the population. A crucial aspect of this activity involves adherence to ethical norms, professional responsibility, and compliance with Good Pharmaceutical Practice. The development of these competencies in future pharmacists begins with the study of the disciplines “Introduction to Pharmacy” and “Ethics and Deontology in Pharmacy”, which form the foundation of professional training. Therefore, the aim of this work was to analyze the significance, key provisions, and role in the formation of professional competence among future pharmacists, as well as the teaching features of the disciplines “Ethics and Deontology in Pharmacy” and “Introduction to Pharmacy” within the course of pharmaceutical management and economics for higher education students at the Faculty of Pharmacy of TNMU. The pharmaceutical profession is based on knowledge from various disciplines, including regulatory frameworks, the organization of pharmacy institutions, drug development technology, and patient communication. One of the key elements of the educational process is familiarizing students with the history of pharmacy development, contemporary trends in the pharmaceutical industry, and the fundamental ethical principles of professional practice. Studying these aspects contributes to the training of highly qualified specialists capable of working effectively in the pharmaceutical sector and ensuring high-quality pharmaceutical care. Particular attention is paid to the development of professional competencies of higher education students through the study of the disciplines “Ethics and Deontology in Pharmacy” and “Introduction to Pharmacy”, which lay the foundation for professional identity, the development of critical thinking, a responsible attitude toward professional duties, and readiness to work under modern challenges. This training involves not only theoretical knowledge acquisition but also active participation in practical classes, discussions, interactive exercises, and situational tasks that simulate real professional scenarios. The formation of moral and ethical qualities in future pharmacists ensures their ability to engage in professional communication, make well-considered decisions in complex situations, and adhere to high standards of pharmaceutical practice. The disciplines “Introduction to Pharmacy” and “Ethics and Deontology in Pharmacy” contribute to the formation of students’ understanding of ethical norms, regulatory frameworks, professional communication, and the specifics of pharmaceutical activity. A significant focus is placed on developing knowledge of modern standards for drug development, manufacturing, and their introduction to the pharmaceutical market. Insufficient awareness among pharmacy students regarding the consequences of unprofessional actions or inaction in their future careers leads to a lack of motivation for studying these disciplines. Therefore, the integration of practical case studies, situational tasks, and the analysis of real-life examples facilitates more effective knowledge acquisition. The teaching of “Introduction to Pharmacy” and “Ethics and Deontology in Pharmacy” plays a crucial role in the training of future pharmacists, ensuring the formation of professional competencies.

The ethical integrity and accountability of Information Technology (IT) professionals is important given our reliance on various forms of IT. We examined the applicability of Lawrence Kohlberg’s theory of Cognitive Moral Development (CMD) in non-Western contexts by investigating the ethical values of IT professionals in Asia’s two largest economies. Analysis of survey data from Japan (n=289) and China (n=290) indicates support for the basic six-stage model of CMD. The concept of abiding by universal laws and rules (termed stage 4 reasoning by Kohlberg) was widely accepted by IT professionals in both Japan and China, despite the Confucian cultural emphasis on personal relationships with particularistic obligations. However, differences between Japanese and Chinese IT professionals were found while, in direct contrast with the stage-wise theory of CMD, the respondents from Japan and especially China exhibited significant volatility, reasoning at different stages simultaneously. The implications of these findings for research and practice are discussed.

As a result of increased concerns regarding ethical issues in engineering, this project assessed the influence on moral reasoning skills of teaching students a course specifically addressing the ethical and social issues in engineering. The Defining Issues Test (DIT), which is based on cognitive moral development theory, was used as the instrument of assessment. Students were pretested, taught a course on engineering ethics, and posttested at the end of the semester. In the Fall of 1995, a total of 301 students participated in the study with 162 students completing the DIT at both the pretest and posttest. In the Spring of 1996, a total of 263 students participated in the study with 155 students completing the DIT at both the pretest and posttest. Analysis of the data revealed a statistically significant increase in the moral reasoning skills of the students for both semesters. Statistical analysis revealed a significant correlation between the change in moral reasoning scores and age in the Spring semester with younger students showing more change but not in the Fall semester. There was no significant relationship between the moral reasoning scores and gender at either the pretest or the posttest, nor in the rate of change by gender. This study demonstrates that the teaching of ethics in engineering can be rigorously measured, tested and analyzed and that it can have a significant positive influence on the moral reasoning skills of the students. However, these findings need to be replicated by other studies in different settings.

This study examined three issues in adult moral development: (a) the relationship between cognitive and moral development; (b) the relationship between social experiences and rate of moral development; and (c) sex differences in moral orientations. Participants were university employees and their spouses. These 62 adults completed a questionnaire regarding social experiences in various areas of their lives. Later they were interviewed to determine their stages of cognitive and moral development and their moral orientation. The results indicated that cognitive development is a necessary but not sufficient condition for moral development. The social experiences that best predicted moral maturity were level of education and extent of joint household decision-making. Little support was found for the notion of sex-related orientations to morality

Haidt’s social intuitionist model: What are the implications for accounting ethics education?

This study was conducted to Exploring the Relationship Between Moral Reasoning and Cognitive Development Among Secondary School Students. Most of the study that has been done on education so far has been about how well students do in school. There hasn't been much research on how students' morals and minds improve. So, the main goal of this study was to explore the relationship between these two important areas of student growth. The study's main goal was to find out what moral reasoning and cognitive growth are made up of in high school students and how they are related to each other.To do this, a validated and modified questionnaire was utilized to find out how students thought about moral reasoning. A group of 1,000 students was chosen from four districts in the Punjab province. Four secondary schools were picked from each district. Two were for girls and two were for boys, and they were chosen at random from both urban and rural areas. Correlation and T-Test were done for results. There was a strong positive relationship between moral reasoning and cognitive development among the students, according to correlation analysis. These results show how important schools are for helping students grow morally and mentally. The study's findings suggest ways to improve teaching methods that support the overall growth of students.

Single item to assess for worry for cancer: Initial evidence of validity and reliability

The purpose of this research is to discuss creative accounting limitation through ethical developments, focusing on features as: measurement and behavior.In this respect we turn to an original search in the literature that comprise together estimation segment in accounting and theoretical developments from behavioral accounting, all with the scope of creating awareness regarding ethics role.After assessing the areas approached, our goal was further to discuss a possible development of a theoretical framework comprising cognitive structures.Important aspects of decision making process were approached and in correlation we discussed the implications that Machiavellian behavior, moral action model and cognitive moral development theory have upon creative accounting measurement and behavior.The originality of the paper consists in the manner we assess the ethics role as the "tone of the top" in the business sector and its implications to measurement and behavior in the area of creative accounting.The findings of our paper indicates that ethics as a solution used for limiting opportunistic behavior in accounting can have an unlimited potential as long term solution.

In the silent corridors of childhood, where maternal presence is expected to provide warmth, guidance, and emotional grounding, the absence of a mother casts a long and often painful shadow. The Shadow of Absence: Ethical Considerations of Growing Up Without a Mother explores the ethical, psychological, and social ramifications of maternal absence. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, presents a thought-provoking analysis of how individuals raised without a mother navigate their personal development, ethical foundations, and emotional resilience. This book unearths the philosophical questions surrounding maternal absence—does morality develop differently in children without a maternal figure? How does society perceive and accommodate those who grow up without a mother? What ethical responsibilities does the community have in addressing the void left by maternal absence? With a deeply humanized and analytical approach, this work does not merely diagnose the struggles of those affected but also seeks pathways for ethical and social reintegration. The discussion extends beyond individual psychology, delving into cultural perspectives, moral philosophy, and policy considerations. Published in New York, USA, in 2023 by The United Nations and The Education Training Centre, this book is an essential read for scholars, ethicists, psychologists, and anyone who seeks a deeper understanding of the intersection between ethics and personal identity formation in the absence of maternal influence. The impetus for this book arises from the growing need to understand the ethical implications of growing up without a mother. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, examines the moral, psychological, and philosophical ramifications of maternal absence in a rapidly evolving world where traditional family structures continue to shift. The book, published in New York, USA, in 2023, seeks to address how individuals construct their identities and ethical foundations in the absence of a maternal figure. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, defines maternal absence beyond physical separation, including emotional detachment and societal neglect. Core concepts include the role of maternal ethics, identity construction, and the moral development of children raised without maternal influence. The book examines theories in developmental psychology, ethics, and cultural philosophy to create a comprehensive framework for understanding this phenomenon. The increasing prevalence of non-traditional family structures has led to a deeper inquiry into the ethical consequences of growing up without a mother. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, highlights empirical studies and case analyses demonstrating the impact of maternal absence on cognitive, emotional, and moral development. The book also explores the long-term societal effects, including shifts in ethical perspectives and social policy. This book follows an interdisciplinary approach, combining psychological analysis, ethical philosophy, and sociological perspectives. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, employs comparative studies to assess differences in moral reasoning and social adaptation between those with and without maternal influence. The book also integrates cross-cultural comparisons to determine how maternal absence is understood and mitigated in various societies. Key indicators include the psychological effects of maternal absence, shifts in moral behavior, and variations in ethical reasoning. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, examines case studies, statistical analyses, and philosophical arguments to explore the extent to which maternal absence influences ethical decision-making and emotional well-being. This book identifies variables such as parental roles, emotional security, ethical decision-making, and social adaptation. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, discusses how these factors interact and shape individual identities in the absence of maternal guidance. Cultural norms, economic conditions, societal support structures, and personal resilience serve as key determinants in how individuals cope with maternal absence. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, investigates the role of extended family, educational institutions, and community resources in shaping moral and ethical development. Through an ethical and philosophical lens, Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, proposes strategies to mitigate the challenges of growing up without a mother. These include fostering inclusive social policies, developing mentorship programs, and creating community support systems to bridge the emotional and moral gaps left by maternal absence. While there are supportive interventions, numerous barriers remain, including societal stigma, economic hardship, and limited access to emotional support. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, discusses how ethical frameworks can guide policy-making to reduce these obstacles. The book concludes by emphasizing the necessity of ethical and social considerations in addressing maternal absence. Prof. Dr. Yoesoep Edhie Rachmad, Ph.D., DBA, argues that while the absence of a mother presents unique challenges, society has an ethical obligation to create frameworks that support those affected, fostering resilience and moral development.

Measuring what matters: a guide to selecting the optimal patient-reported outcome measure for pediatric shoulder and elbow function.

Contents: Preface. J.R. Rest, Background: Theory and Research. S.P. McNeel, College Teaching and Student Moral Development. L.J. Duckett, M.B. Ryden, Education for Ethical Nursing Practice. F-Y. Chang, School Teachers' Moral Reasoning. N.A. Sprinthall, Counseling and Social Role Taking: Promoting Moral and Ego Development. L.A. Ponemon, D.R.L. Gabhart, Ethical Reasoning Research in the Accounting and Auditing Professions. M.J. Bebeau, Influencing the Moral Dimensions of Dental Practice. D.J. Self, D.C. Baldwin, Jr., Moral Reasoning in Medicine. D.J. Self, M. Olivarez, D.C. Baldwin, Jr., Moral Reasoning in Veterinary Medicine. B.J.L. Bredemeier, D.L.L. Shields, Applied Ethics and Moral Reasoning in Sport. T. Westbrook, Tracking the Moral Development of Journalists: A Look at Them and Their Work. S. Thoma, Moral Judgments and Moral Action. J.R. Rest, D. Narvaez, Summary: What's Possible?

The topic areas of this chapter are ones that are not often dealt with together, namely attitude/behavior consistency and cognitive moral development, in particular Kohlberg’s (1969) stages of moral development. Our purpose is to suggest that these two research areas are more closely related than is usually thought. To state our theme briefly, we suggest that consistency and inconsistency are related to moral development as a cause and a consequence of moral growth. As a consequence, several studies are discussed that appear to show that the motive to maintain consistency between attitudes and behavior is stronger among persons at higher stages of moral development, an effect that seems to be related to differences in the weighting of attitudes relative to other influences on behavior (e.g., group opinion) by persons in the different moral stages. These studies examine (a) the correlation between attitudes and behavior as a function of moral level, (b) the influence of persuasion and attitude change on behavior at different stages, and (c) the influence of counter-attitudinal advocacy on attitude change as a function of stage. All three types of studies show a closer interrelatedness between attitudes and behaviors among persons at higher levels of development.

Parent-child play is a beneficial and meaningful co-occupation. Therapists who want to optimize parent-child play for Latino- and Latina-American dyads need valid, reliable measures to assess caregiver playfulness in addition to preexisting measures of child playfulness. To evaluate data collected from Latino-American caregivers with the Scale of Parental Playfulness Attitude (PaPA), a 28-item parent self-report to determine its construct validity, internal reliability, and cross-cultural validity. Quantitative exploratory design applying a latent-trait psychometric model. Online survey. Convenience sample of 50 Spanish-speaking parents from the mainland United States recruited via snowballing (88% mothers, ages 24-47 yr; M = 34.8 yr; 82% first-generation Americans). The inclusion criteria were age ≥18 yr; literate in Spanish; primary caregiver to a child age 2.5-7 yr. Data from an existing sample of 50 parents dwelling in Puerto Rico were used to examine cross-cultural validity. Rasch analysis demonstrated evidence for adequate construct validity: positive point-measure correlations, 93% fit of items, logical item hierarchy, and good progression of the rating scale. Range and mean for parent playfulness exceeded those of the items; principal-components analysis revealed one contrast of 4.46 eigenvalues, bringing unidimensionality into question. Evidence suggested excellent internal reliability (person-reliability index = 0.85, strata = 3.55) and good cross-cultural validity (25 of 28 items formed a similar hierarchy for parents dwelling in the mainland United States and Puerto Rico). Although the PaPA can be used to assess caregiver playfulness with culturally diverse Latino-American dyads, further research is required. What This Article Adds: This study provides evidence for the construct validity and internal reliability of a tool that measures parent playfulness in the context of parent-child play. The PaPA is an important tool for occupational therapists working with Latino-American families.