An Investigation into the Role of Professional Affiliation and How This May Effect Moral Competence Through Moral Dilemma Analysis

Regressions and stagnations in moral development are increasing being reported within the literature, mainly emanating from medical and healthcare vocations. Reasons surrounding these findings report links to certain educational deficiencies which fail to facilitate moral growth. However, some studies have proposed the occurrence of a moral segmentation effect, through the use of hypothetical moral dilemmas, namely those detailing acts of euthanasia. Utilising the Moral Competence Test (MCT, Lind, 2008a) the present research intended to shed light on this disparity. A total of 247 university students, 118 healthcare professions and 150 non-healthcare professionals were recruited. Questionnaires were mainly completed online, with a small portion of the student sample (38%) being completed online. Research study one examined the theoretical validity of The Moral Competence Test, which was successfully substantiated. Research study two explored moral competence levels of healthcare and non-healthcare vocational fields in education and practice, examined the relationship between moral competence and educational factors and explored the occurrence of a moral segmentation effect. Findings revealed that all vocational fields displayed low moral competence. Interactive and non-interactive teaching methods had a minimal relationship with moral competence. Results indicated the presence of a moral segmentation effect within medical and healthcare professionals and a trend in students. Both medical and healthcare students and professionals obtained lower moral competence scores within the mercy killing scenario. Research study three examined the vigilantism and mercy killing moral dilemmas independently through the application of utilitarianism and deontological philosophies to investigate whether different vocational fields differ in their ethical compositions. Findings revealed medical and healthcare vocational fields displayed a higher rejection if utilitarian arguments and a higher acceptance of deontological arguments in the mercy killing scenario, when compared to non-healthcare vocational fields. No significant differences were noted in the vigilantism scenario. Moral competence positively correlated with utilitarian compositions. Research study four assessed individual differences through the exploration of personality and emotional intelligence and the relationship with vocational choice, moral competence and ethical compositions. Findings within the student samples revealed that business students displayed higher levels of Machiavellianism and narcissism compared to medical and healthcare students. Within practice samples, non-healthcare vocations displayed higher levels of psychopathy than healthcare professionals. No significant differences were found between vocational fields in levels of emotional intelligence. The Dark Triad and emotional intelligence held minimal relations with moral competence scores. Utilitarian compositions were positively related to Machiavellianism, narcissism, psychopathy and negatively with total emotional intelligence. Research study five explored levels of moral distress and its relationship moral competence, ethical compositions, personality, emotional intelligence and ethical climate within UK healthcare environments. Findings revealed that nurses displayed higher levels of moral distress than physicians, though this was not significant. Emotional Reasoning and emotional self-management were negatively associated with moral distress in the nurse sample. Machiavellianism and narcissism held differing roles to moral distress between physicians and nurses. Moral distress negatively correlated with moral competence in the physician sample and a positively in the nurse sample. Moral distress held significant negative correlations with total utilitarian support and positive correlations with total deontological support in the physician sample. The contextual elements and potential biases present in the use of hypothetical moral dilemmas, coupled with vocational affiliation are discussed in detail. Relations to individual differences through the measure of the dark personality traits, emotional intelligence and moral distress occurrence within medical and healthcare practice are also discussed.