Data from this descriptive-correlational study offered additional support for the validity of the moral intuitionist model of virtuous caring. Applied to medical character education, medical school programs should consider designing educational experiences that intentionally emphasize the cultivation of virtue.
Despite widespread pedagogical efforts to modify discrete behaviors in developing physicians, the professionalism movement has generally shied away from essential questions such as what virtues characterize the good physician, and how are those virtues formed? Although there is widespread adoption of medical ethics curricula, there is still no consensus about the primary goals of ethics education. Two prevailing perspectives dominate the literature, constituting what is sometimes referred to as the "virtue/skill dichotomy". The first perspective argues that teaching ethics is a means of providing physicians with a skill set for analyzing and resolving ethical dilemmas. The second perspective suggests that teaching ethics is a means of creating virtuous physicians. The authors argue that this debate about medical ethics education mirrors the Rationalist-Intuitionist debate in contemporary moral psychology. In the following essay, the authors sketch the relevance of the Rationalist-Intuitionist debate to medical ethics and professionalism. They then outline a moral intuitionist model of virtuous caring that derives from but also extends the "social intuitionist model" of moral action and virtue. This moral intuitionist model suggests several practical implications specifically for medical character education but also for health science education in general. This approach proposes that character development is best accomplished by tuning-up (activating) moral intuitions, amplifying (intensifying) moral emotions related to intuitions, and strengthening (expanding) intuition-expressive, emotion-related moral virtues, more than by "learning" explicit ethical rules or principles.
Meaning-system analyses presently dominate the literature on religious conversion and spiritual transformation (Paloutzian & Park, 2005). To complement (not contradict) meaning-system analyses this three-article series proposes the construction of a new approach to the study of the affective basis of spiritual transformation, moral motive analysis. The objective of this final article is to outline a specific moral motive analysis of transformation, a “social intuitionist” (Haidt, 2001) approach that both complements and elaborates the theological tradition of orthokardia (Runyon, 1998). This article first summarizes the central hermeneutic and defining features of orthodardia, and then relates them to concepts in contemporary moral motivation theory. Second, following the Murphy-MacIntyrean framework (telos, problem, purpose), it proposes three core postulates concerning the role of moral emotions in spiritual transformation: moral telos as emerging love and the capable character; moral problem as the duplicitous heart and diminished capacity to love; and moral process as implicit relational transformation. Collectively, these postulates delineate an approach to relational affect transformation (virtue-acquisition and vice-diminishment) that is consistent with the sensibilities of Aristotelean virtue ethics (MacIntyre, 1984), contemporary moral motive theory (Emmons & McCullough, 2004), and the apophatic approach to change (Jones, 2002), thus providing a metapsychology of implicit relational spirituality for theory, research, and practice.
Contemporary thinking in generativity theory and research (de St. Aubin, McAdams, & Kim, 2004) and in the “psychology of ultimate concerns” (Emmons, 1999) posits that Erik Erikson's notion of generativity is a multi-faceted construct concerned with the moral telos of positive psychological growth, but one that has yet to be satisfactorily explored. The current article draws on some of Erikson's (2000) less-cited descriptions of generativity to propose a new domain for generativity theory and research, termed relational generativity. Relational generativity is conceptualized as the motive and capacity to take care of the strengths-development of cared for others, and is delineated as (a) a moral telos (to be pursued), (b) a motive (to be activated), (c) a psychological capacity (to be developed), and (d) an investment (to be given). Christian ethicist Don Browning (2006) suggests that these features substantively outline Erikson's relational ethic of “generative mutuality” and provide a view of relational well-being that potentially enriches the Christian understanding of neighbor-love. Suggestions for continued theoretical and empirical development of relational generativity, and its relevance to the relational spirituality paradigm are offered. Collectively this three-article series extends the author's recent proposal for a moral motive approach to emotion and transformation (Leffel, 2007a, 2007b, 2007c).
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