Moral injury

وَلَا تَأۡكُلُوٓاْ أَمۡوَٰلَكُم بَيۡنَكُم بِٱلۡبَٰطِلِ وَتُدۡلُواْ بِهَآ إِلَى ٱلۡحُكَّامِ لِتَأۡكُلُواْ فَرِيقࣰ ا مِّنۡ أَمۡوَٰلِ ٱلنَّاسِ بِٱلۡإِثۡمِ وَأَنتُمۡ تَعۡلَمُونَ

Do not consume your property wrongfully, nor use it to bribe judges, intending sinfully and knowingly to consume parts of other people’s property

وَإِذَا قِيلَ لَهُ ٱتَّقِ ٱللَّهَ أَخَذَتۡهُ ٱلۡعِزَّةُ بِٱلۡإِثۡمِۚ فَحَسۡبُهُۥ جَهَنَّمُۖ وَلَبِئۡسَ ٱلۡمِهَادُ

When he is told, ‘Beware of God,’ his arrogance leads him to sin. Hell is enough for him: a dreadful resting place

ثُمَّ أَنتُمۡ هَٰٓؤُلَآءِ تَقۡتُلُونَ أَنفُسَكُمۡ وَتُخۡرِجُونَ فَرِيقࣰ ا مِّنكُم مِّن دِيَٰرِهِمۡ تَظَٰهَرُونَ عَلَيۡهِم بِٱلۡإِثۡمِ وَٱلۡعُدۡوَٰنِ وَإِن يَأۡتُوكُمۡ أُسَٰرَىٰ تُفَٰدُوهُمۡ وَهُوَ مُحَرَّمٌ عَلَيۡكُمۡ إِخۡرَاجُهُمۡۚ أَفَتُؤۡمِنُونَ بِبَعۡضِ ٱلۡكِتَٰبِ وَتَكۡفُرُونَ بِبَعۡضࣲۚ فَمَا جَزَآءُ مَن يَفۡعَلُ ذَٰلِكَ مِنكُمۡ إِلَّا خِزۡيࣱ فِي ٱلۡحَيَوٰةِ ٱلدُّنۡيَاۖ وَيَوۡمَ ٱلۡقِيَٰمَةِ يُرَدُّونَ إِلَىٰٓ أَشَدِّ ٱلۡعَذَابِۗ وَمَا ٱللَّهُ بِغَٰفِلٍ عَمَّا تَعۡمَلُونَ

Yet here you are, killing one another and driving some of your own people from their homes, helping one another in sin and aggression against them. If they come to you as captives, you still pay to set them free, although you had no right to drive them out. So do you believe in some parts of the Scripture and not in others? The punishment for those of you who do this will be nothing but disgrace in this life, and on the Day of Resurrection they will be condemned to the harshest torment: God is not unaware of what you do

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ لَا تُحِلُّواْ شَعَٰٓئِرَ ٱللَّهِ وَلَا ٱلشَّهۡرَ ٱلۡحَرَامَ وَلَا ٱلۡهَدۡيَ وَلَا ٱلۡقَلَٰٓئِدَ وَلَآ ءَآمِّينَ ٱلۡبَيۡتَ ٱلۡحَرَامَ يَبۡتَغُونَ فَضۡلࣰ ا مِّن رَّبِّهِمۡ وَرِضۡوَٰنࣰ اۚ وَإِذَا حَلَلۡتُمۡ فَٱصۡطَادُواْۚ وَلَا يَجۡرِمَنَّكُمۡ شَنَـَٔانُ قَوۡمٍ أَن صَدُّوكُمۡ عَنِ ٱلۡمَسۡجِدِ ٱلۡحَرَامِ أَن تَعۡتَدُواْۘ وَتَعَاوَنُواْ عَلَى ٱلۡبِرِّ وَٱلتَّقۡوَىٰۖ وَلَا تَعَاوَنُواْ عَلَى ٱلۡإِثۡمِ وَٱلۡعُدۡوَٰنِۚ وَٱتَّقُواْ ٱللَّهَۖ إِنَّ ٱللَّهَ شَدِيدُ ٱلۡعِقَابِ

so, you who believe, do not violate the sanctity of God’s rites, the Sacred Month, the offerings, their garlands, nor those going to the Sacred House to seek the bounty and pleasure of their Lord––but when you have completed the rites of pilgrimage you may hunt. Do not let your hatred for the people who barred you from the Sacred Mosque induce you to break the law: help one another to do what is right and good; do not help one another towards sin and hostility. Be mindful of God, for His punishment is severe

وَتَرَىٰ كَثِيرࣰ ا مِّنۡهُمۡ يُسَٰرِعُونَ فِي ٱلۡإِثۡمِ وَٱلۡعُدۡوَٰنِ وَأَكۡلِهِمُ ٱلسُّحۡتَۚ لَبِئۡسَ مَا كَانُواْ يَعۡمَلُونَ

You [Prophet] see many of them rushing into sin and hostility and consuming what is unlawful. How evil their practices are

لَوۡلَا يَنۡهَىٰهُمُ ٱلرَّبَّٰنِيُّونَ وَٱلۡأَحۡبَارُ عَن قَوۡلِهِمُ ٱلۡإِثۡمَ وَأَكۡلِهِمُ ٱلسُّحۡتَۚ لَبِئۡسَ مَا كَانُواْ يَصۡنَعُونَ

Why do their rabbis and scholars not forbid them to speak sinfully and consume what is unlawful? How evil their deeds are

(And eat not up your property among yourselves in vanity�) [2:188]. Said Muqatil ibn Hayyan: �This verse was revealed about Imra' al-Qays ibn 'Abis al-Kindi and 'Abdan ibn Ashu' al-Hadrami. It so happened that these two men came to the Prophet, Allah bless him and give him peace, with a dispute regarding a piece of land. Imra' al-Qays had the land and 'Abdan was reclaiming it. And so Allah, exalted is He, revealed this verse, and the land was given to 'Abdan without a judgment pronouncement�.

(O ye who believe! Profane not Allah�s monuments�) [5:2]. Said Ibn �Abbas: �This was revealed about al-Hutam whose full name is Sharih ibn Dubay�ah al-Kindi. This man went from al-Yamamah to Medina to see the Prophet, Allah bless him and his Household and give him peace. When he arrived at Medina, he went in alone to speak with the Prophet, Allah bless him and give him peace. He said: �What do you call people for?� he said: �To testify that there is no god but Allah, to establish the prayer and to pay the poor due�. The man said: �This is good, except that I have chiefs without whose consultation I cannot take any decision. It may be that I embrace Islam and bring them with me�. And then he left. Before this, the Prophet, Allah bless him and give him peace, had said to his Companions: �A man will enter in on you and will speak with the tongue of the devil�. When the man left, the Messeng

Consume not your goods between you that is to say do not let one consume the goods of the other in deception that which is illicit according to the Law such as theft and extortion; and do not proffer them the regulation of these goods or any bribes to the judges that you may consume as a result of any arbitration a portion of other people’s goods embroiled in sin while you are aware that you are in error.

And when it is said to him ‘Fear God’ in your actions he is seized by vainglory pride and rage in his sin the one he was commanded to avoid committing. So Hell shall be enough it suffices for him — how evil a cradling a resting place it is!

Then there you are killing one another and expelling a party of you from their habitations conspiring tazzāharūna the original ta’ has been assimilated with the zā’; a variant reading has it without the assimilation that is tazāharūna assisting one another against them in sin in disobedience and enmity injustice and if they come to you as captives a variant reading for usārā has asrā you ransom them a variant reading for tafdūhum has tufādūhum that is to say you deliver them from captivity with money etc. and this ransoming was one of the things to which they were pledged; yet their expulsion was forbidden you muharramun ‘alaykum ikhrājuhum is semantically connected to wa-tukhrijūna ‘and expelling’ and the statement that comes in between is parenthetical that is expulsion was forbidden you in the same way that non-ransoming was forbidden you. Qurayza had allied themselves with the Aws an

And (remember) when We took your covenant (saying): Shed not the blood of your (people), nor turn out your own people from their dwellings. Then, (this) you ratified and (to this) you bore witness (84)After this, it is you who kill one another and drive out a party of you from their homes, assist (their enemies) against them, in sin and transgression. And if they come to you as captives, you ransom them, although their expulsion was forbidden to you. Then do you believe in a part of the Book and reject the rest? Then what is the recompense of those who do so among you, except disgrace in the life of this world, and on the Day of Resurrection they shall be consigned to the most grievous torment. And Allah is not unaware of what you do (85)Those are they who have bought the life of this world at the price of the Hereafter. Their torment shall not be lightened nor shall they be helped (86)

حَدَّثَنَا أَحْمَدُ بْنُ يُونُسَ، حَدَّثَنَا أَبُو شِهَابٍ، عَنِ ابْنِ عَوْنٍ، عَنْ مُجَاهِدٍ، عَنْ عَبْدِ الرَّحْمَنِ بْنِ أَبِي لَيْلَى، عَنْ كَعْبِ بْنِ عُجْرَةَ، قَالَ أَتَيْتُهُ يَعْنِي النَّبِيَّ صلى الله عليه وسلم فَقَالَ ‏"‏ ادْنُ ‏"‏‏.‏ فَدَنَوْتُ فَقَالَ ‏"‏ أَيُؤْذِيكَ هَوَامُّكَ ‏"‏‏.‏ قُلْتُ نَعَمْ‏.‏ قَالَ ‏"‏ فِدْيَةٌ مِنْ صِيَامٍ أَوْ صَدَقَةٍ أَوْ نُسُكٍ ‏"‏‏.‏ وَأَخْبَرَنِي ابْنُ عَوْنٍ عَنْ أَيُّوبَ قَالَ صِيَامُ ثَلاَثَةِ أَيَّامٍ، وَالنُّسُكُ شَاةٌ، وَالْمَسَاكِينُ سِتَّةٌ‏.‏

Narrated Ka`b bin 'Ujra:I came to the Prophet (ﷺ) and he said to me, "Come near." So I went near to him and he said, "Are your lice troubling you?" I replied, "Yes." He said, "(Shave your head and) make expiation in the form of fasting, Sadaqa (giving in charity), or offering a sacrifice." (The sub-narrator) Aiyub said, "Fasting should be for three days, and the Nusuk (sacrifice) is to be a sheep, and the Sadaqa is to be given to six poor persons

حَدَّثَنَا عَلِيُّ بْنُ عَبْدِ اللَّهِ، حَدَّثَنَا سُفْيَانُ، عَنِ الزُّهْرِيِّ، قَالَ سَمِعْتُهُ مِنْ، فِيهِ عَنْ حُمَيْدِ بْنِ عَبْدِ الرَّحْمَنِ، عَنْ أَبِي هُرَيْرَةَ، قَالَ جَاءَ رَجُلٌ إِلَى النَّبِيِّ صلى الله عليه وسلم فَقَالَ هَلَكْتُ‏.‏ قَالَ ‏"‏ مَا شَأْنُكَ ‏"‏‏.‏ قَالَ وَقَعْتُ عَلَى امْرَأَتِي فِي رَمَضَانَ‏.‏ قَالَ ‏"‏ تَسْتَطِيعُ تُعْتِقُ رَقَبَةً ‏"‏‏.‏ قَالَ لاَ‏.‏ قَالَ ‏"‏ فَهَلْ تَسْتَطِيعُ أَنْ تَصُومَ شَهْرَيْنِ مُتَتَابِعَيْنِ ‏"‏‏.‏ قَالَ لاَ‏.‏ قَالَ ‏"‏ فَهَلْ تَسْتَطِيعُ أَنْ تُطْعِمَ سِتِّينَ مِسْكِينًا ‏"‏‏.‏ قَالَ لاَ‏.‏ قَالَ ‏"‏ اجْلِسْ ‏"‏‏.‏ فَجَلَسَ فَأُتِيَ النَّبِيُّ صلى الله عليه وسلم بِعَرَقٍ فِيهِ تَمْرٌ ـ وَالْعَرَقُ الْمِكْتَلُ الضَّخْمُ ـ قَالَ ‏"‏ خُذْ هَذَا، فَتَصَدَّقْ بِهِ ‏"‏‏.‏ قَالَ أَعَلَى أَفْقَرَ مِنَّا، فَضَحِكَ النَّبِيُّ صلى الله عليه وسلم حَتَّى بَدَتْ نَوَاجِذُهُ قَالَ ‏"‏ أَطْعِمْهُ عِيَالَكَ ‏"‏‏.‏

Narrated Abu Huraira:A man came to the Prophet (ﷺ) and said, "I am ruined!" The Prophet (ﷺ) said, "What is the matter with you?" He said, "I had sexual relation with my wife (while I was fasting) in Ramadan." The Prophet (ﷺ) said, "Have you got enough to manumit a slave?" He said, "No." The Prophet (ﷺ) said, "Can you fast for two successive months?" The man said, "No." The Prophet (ﷺ) said, "Can you feed sixty poor persons?" The man said, "No." Then the Prophet (ﷺ) said to him, "Sit down," and he sat down. Afterwards an 'Irq, i.e., a big basket containing dates was brought to the Prophet (ﷺ) and the Prophet (ﷺ) said to him, "Take this and give it in charity." The man said, "To poorer people than we?" On that, the Prophet (ﷺ) smiled till his premolar teeth became visible, and then told him, "Feed your family with it." (See Hadith No. 157, Vol)

حَدَّثَنَا قُتَيْبَةُ، حَدَّثَنَا أَبُو صَفْوَانَ، عَنْ يُونُسَ بْنِ يَزِيدَ، عَنِ ابْنِ شِهَابٍ، عَنْ أَبِي سَلَمَةَ، عَنْ عَائِشَةَ، قَالَتْ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ لاَ نَذْرَ فِي مَعْصِيَةٍ وَكَفَّارَتُهُ كَفَّارَةُ يَمِينٍ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنِ ابْنِ عُمَرَ وَجَابِرٍ وَعِمْرَانَ بْنِ حُصَيْنٍ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ لاَ يَصِحُّ لأَنَّ الزُّهْرِيَّ لَمْ يَسْمَعْ هَذَا الْحَدِيثَ مِنْ أَبِي سَلَمَةَ ‏.‏ قَالَ سَمِعْتُ مُحَمَّدًا يَقُولُ رَوَى غَيْرُ وَاحِدٍ مِنْهُمْ مُوسَى بْنُ عُقْبَةَ وَابْنُ أَبِي عَتِيقٍ عَنِ الزُّهْرِيِّ عَنْ سُلَيْمَانَ بْنِ أَرْقَمَ عَنْ يَحْيَى بْنِ أَبِي كَثِيرٍ عَنْ أَبِي سَلَمَةَ عَنْ عَائِشَةَ عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏ قَالَ مُحَمَّدٌ وَالْحَدِيثُ هُوَ هَذَا ‏.‏

Narrated 'Aishah:That the Messenger of Allah (ﷺ) said: "There is no vowing for disobedience, and its atonement is the atonement of an oath

حَدَّثَنَا أَبُو إِسْمَاعِيلَ التِّرْمِذِيُّ، - وَاسْمُهُ مُحَمَّدُ بْنُ إِسْمَاعِيلَ بْنِ يُوسُفَ حَدَّثَنَا أَيُّوبُ بْنُ سُلَيْمَانَ بْنِ بِلاَلٍ، حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي أُوَيْسٍ، عَنْ سُلَيْمَانَ بْنِ بِلاَلٍ، عَنْ مُوسَى بْنِ عُقْبَةَ، وَمُحَمَّدِ بْنِ عَبْدِ اللَّهِ بْنِ أَبِي عَتِيقٍ، عَنِ الزُّهْرِيِّ، عَنْ سُلَيْمَانَ بْنِ أَرْقَمَ، عَنْ يَحْيَى بْنِ أَبِي كَثِيرٍ، عَنْ أَبِي سَلَمَةَ، عَنْ عَائِشَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ لاَ نَذْرَ فِي مَعْصِيَةِ اللَّهِ وَكَفَّارَتُهُ كَفَّارَةُ يَمِينٍ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ غَرِيبٌ وَهُوَ أَصَحُّ مِنْ حَدِيثِ أَبِي صَفْوَانَ عَنْ يُونُسَ ‏.‏ وَأَبُو صَفْوَانَ هُوَ مَكِّيٌّ وَاسْمُهُ عَبْدُ اللَّهِ بْنُ سَعِيدِ بْنِ عَبْدِ الْمَلِكِ بْنِ مَرْوَانَ وَقَدْ رَوَى عَنْهُ الْحُمَيْدِيُّ وَغَيْرُ وَاحِدٍ مِنْ جِلَّةِ أَهْلِ الْحَدِيثِ ‏.‏ وَقَالَ قَوْمٌ مِنْ أَهْلِ الْعِلْمِ مِنْ أَصْحَابِ النَّبِيِّ صلى الله عليه وسلم وَغَيْرِهِمْ لاَ نَذْرَ فِي مَعْصِيَةِ اللَّهِ وَكَفَّارَتُهُ كَفَّارَةُ يَمِينٍ ‏.‏ وَهُوَ قَوْلُ أَحْمَدَ وَإِسْحَاقَ وَاحْتَجَّا بِحَدِيثِ الزُّهْرِيِّ عَنْ أَبِي سَلَمَةَ عَنْ عَائِشَةَ ‏.‏ وَقَالَ بَعْضُ أَهْلِ الْعِلْمِ مِنْ أَصْحَابِ النَّبِيِّ صلى الله عليه وسلم وَغَيْرِهِمْ لاَ نَذْرَ فِي مَعْصِيَةٍ وَلاَ كَفَّارَةَ فِي ذَلِكَ ‏.‏ وَهُوَ قَوْلُ مَالِكٍ وَالشَّافِعِيِّ ‏.‏

Narrated 'Aishah:That the Prophet (ﷺ) said: "There is no vowing in disobedience to Allah, and its atonement is the atonement of an oath

حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا مُحَمَّدُ بْنُ مُصْعَبٍ، عَنِ الأَوْزَاعِيِّ، عَنْ يَحْيَى بْنِ أَبِي كَثِيرٍ، عَنْ هِلاَلِ بْنِ أَبِي مَيْمُونَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ رِفَاعَةَ الْجُهَنِيِّ، قَالَ كَانَ النَّبِيُّ ـ صلى الله عليه وسلم ـ إِذَا حَلَفَ قَالَ ‏ "‏ وَالَّذِي نَفْسُ مُحَمَّدٍ بِيَدِهِ ‏"‏ ‏.‏

It was narrated that Rifa'ah Al - Juhani said:"When the Prophet (ﷺ) took an oath he would say: 'By the One in Whose Hand is the soul of Muhammad

حَدَّثَنَا هِشَامُ بْنُ عَمَّارٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ مُحَمَّدٍ الصَّنْعَانِيُّ، حَدَّثَنَا الأَوْزَاعِيُّ، عَنْ يَحْيَى بْنِ أَبِي كَثِيرٍ، عَنْ هِلاَلِ بْنِ أَبِي مَيْمُونَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ رِفَاعَةَ بْنِ عَرَابَةَ الْجُهَنِيِّ، قَالَ كَانَتْ يَمِينُ رَسُولِ اللَّهِ ـ صلى الله عليه وسلم ـ التَّى يَحْلِفُ بِهَا أَشْهَدُ عِنْدَ اللَّهِ ‏ "‏ وَالَّذِي نَفْسِي بِيَدِهِ ‏"‏ ‏.‏

It was narrated that Rifa'ah bin 'Arabah A-Juhani said:"The swearing of the Messenger of Allah (ﷺ) when he took an oath and I bear witness before Allah was: 'By the One in Whose Hand is my soul

ومنها : مشابهة اليهود والنصارى في اتخاذ المساجد والسرج عليها ومنها : محادة الله ورسوله ومناقضة ما شرعه فيها ومنها : التعب العظيم مع الوزر الكثير والإثم العظيم ومنها : إماتة السنن وإحياء البدع

تجنبت إتيان الحبيب تأثما % إلا أن هجران الحبيب هو الإثم

| فصل وأما الإثم والعدوان فهما قرينان قال الله تعالى وتعاونوا على

فالإثم ما كان محرم الجنس كالكذب والزنا وشرب الخمر ونحو ذلك والعدوان ما كان محرم القدر والزيادة

والعرب تقول في وصف الرجل بالصدق والوفاء : طاهر الثياب وتقول للغادر والفاجر : دنس الثياب وقال أبي بن كعب : لا تلبسها على الغدر والظلم والإثم ولكن البسها وأنت بر طاهر

التحرج الخروج من حرج المخالفة وبناء تفعل يكون للدخول في الشيء كتمنى إذا دخل في الأمنية وتولج في الأمر : دخل فيه ونحوه وللخروج منه كتحرج وتحوب وتأثم إذا أراد الخروج من الحرج والحوب : هو الإثم

Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies.: Objective: At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns with their own values; a phenomenon known as moral distress. Similarly, there are increasing reports of healthcare workers experiencing long-term mental and psychological pain, alongside internal dissonance, known as moral injury. This review examined the triggers and factors associated with moral distress

Measuring moral distress and moral injury: A systematic review and content analysis of existing scales.: Background: Moral distress (MD) and moral injury (MI) are related constructs describing the negative consequences of morally challenging stressors. Despite growing support for the clinical relevance of these constructs, ongoing challenges regarding measurement quality risk limiting research and clinical advances. This study summarizes the nature, quality, and utility of existing MD and MI scales, and provides recommendations for future use. Method: We identified psychometric studies describing t

Prevalence, Predictors, and Experience of Moral Suffering in Nursing and Care Home Staff during the COVID-19 Pandemic: A Mixed-Methods Systematic Review.: (1) Background: Nursing and care home staff experienced high death rates of older residents and increased occupational and psychosocial pressures during the COVID-19 pandemic. The literature has previously found this group to be at risk of developing mental health conditions, moral injury (MI), and moral distress (MD). The latter two terms refer to the perceived ethical wrongdoing which contravenes an individual's moral beliefs and elicits adverse emotional responses. (2) Method: A systematic re

Instruments to assess moral distress among healthcare workers: A systematic review of measurement properties.: Background: An increasing number of professionals are challenged by the evolution of modern healthcare and society, often characterized by more expectations with reduced resources. Moral distress is among the psychophysical conditions now most under investigation in order to improve the wellbeing of professionals, the sustainability of organizations and the quality of care. Over the last decades, several instruments have been developed to assess the frequency or intensity of moral distress in di

Ethics education to support ethical competence learning in healthcare: an integrative systematic review.: Background: Ethical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the avail

Influence of the ethical climate on workers' health among healthcare professionals: a systematic review.: Objective: To evaluate the influence of the ethical climate on workers' health among healthcare professionals. Method: Systematic review and meta-analysis conducted in MEDLINE/PubMed, EMBASE, SciVerse Scopus (Elsevier), Cumulative Index to Nursing and Allied Health Literature and Web of Science. Trained reviewers performed the selection, data extraction, and assessment of methodological quality. Meta-analysis was applied for data synthesis. Results: Among the 2644 studies, 20 were included for a

Neurodegeneration and Identity.

There is a widespread notion, both within the sciences and among the general public, that mental deterioration can rob individuals of their identity. Yet there have been no systematic investigations of what types of cognitive damage lead people to appear to no longer be themselves. We measured perceived identity change in patients with three kinds of neurodegenerative disease: frontotemporal dementia, Alzheimer's disease, and amyotrophic lateral sclerosis. Structural equation models revealed that injury to the moral faculty plays the primary role in identity discontinuity. Other cognitive deficits, including amnesia, have no measurable impact on identity persistence. Accordingly, frontotemporal dementia has the greatest effect on perceived identity, and amyotrophic lateral sclerosis has the least. We further demonstrated that perceived identity change fully mediates the impact of neurode…

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The development of bystander intentions and social-moral reasoning about intergroup verbal aggression.

A developmental intergroup approach was taken to examine the development of prosocial bystander intentions among children and adolescents. Participants as bystanders (N = 260) aged 8-10 and 13-15 years were presented with scenarios of direct aggression between individuals from different social groups (i.e., intergroup verbal aggression). These situations involved either an ingroup aggressor and an outgroup victim or an outgroup aggressor and an ingroup victim. This study focussed on the role of intergroup factors (group membership, ingroup identification, group norms, and social-moral reasoning) in the development of prosocial bystander intentions. Findings showed that prosocial bystander intentions declined with age. This effect was partially mediated by the ingroup norm to intervene and perceived severity of the verbal aggression. However, a moderated mediation analysis showed that onl…

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Autonomic and prefrontal events during moral elevation.

Moral elevation, or elevation, is a specific emotional state triggered by witnessing displays of profound virtue and moral beauty. This study set out to characterize the physiology underlying elevation with measurements of heart rate (HR), respiratory sinus arrhythmia (RSA), and medial prefrontal cortex (mPFC) activity. During elevation, HR and RSA increased. These findings illustrate that elevation involves an uncommon combination of both sympathetic and parasympathetic activation, which is present in circumstances where arousal and social engagement are both required. In addition, we show evidence of content-dependent alterations of mPFC activity during elevation peaks. Altogether, this study shows that the induction of moral elevation recruits an uncommon autonomic and neural pattern that is consistent with previous understanding of socioemotional-induced allostasis.

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Doing good medical ethics: a Christian perspective.

Despite the rise of the secular state, religion remains a significant force in society. Within Christianity this encompasses a wide variety of beliefs. These range from simple assertions of theism in a cultural context to complex theologies; from liberal emphases on uncertainty and exploration to dogmatic views of divine revelation. How one 'does' good medical ethics depends on these perspectives. Contingently, the Christian contribution to medical ethics has been huge and constructive. Central to that contribution is a core belief in the intrinsic value of human life, respect for which we are accountable to God. Christianity continues to deserve its place 'in the public square' and, specifically, in medical ethical discourse.

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Empathic concern drives costly altruism.

Why do we self-sacrifice to help others in distress? Two competing theories have emerged, one suggesting that prosocial behavior is primarily motivated by feelings of empathic other-oriented concern, the other that we help mainly because we are egoistically focused on reducing our own discomfort. Here we explore the relationship between costly altruism and these two sub-processes of empathy, specifically drawing on the caregiving model to test the theory that trait empathic concern (e.g. general tendency to have sympathy for another) and trait personal distress (e.g. predisposition to experiencing aversive arousal states) may differentially drive altruistic behavior. We find that trait empathic concern--and not trait personal distress--motivates costly altruism, and this relationship is supported by activity in the ventral tegmental area, caudate and subgenual anterior cingulate, key reg…

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Social-economical decision making in current and remitted major depression.

Background: Prosocial emotions related to self-blame are important in guiding human altruistic decisions. These emotions are elevated in major depressive disorder (MDD), such that MDD has been associated with guilt-driven pathological hyper-altruism. However, the impact of such emotional impairments in MDD on different types of social decision-making is unknown. Method: In order to address this issue, we investigated different kinds of altruistic behaviour (interpersonal cooperation and fund allocation, altruistic punishment and charitable donation) in 33 healthy subjects, 35 patients in full remission (unmedicated) and 24 currently depressed patients (11 on medication) using behavioural-economical paradigms. Results: We show a significant main effect of clinical status on altruistic decisions (p = 0.04) and a significant interaction between clinical status and type of altruistic decisio…

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Abnormal brain responses to social fairness in depression: an fMRI study using the Ultimatum Game.

Background: Depression is a prevalent disorder that significantly affects the social functioning and interpersonal relationships of individuals. This highlights the need for investigation of the neural mechanisms underlying these social difficulties. Investigation of social exchanges has traditionally been challenging as such interactions are difficult to quantify. Recently, however, neuroeconomic approaches that combine multiplayer behavioural economic paradigms and neuroimaging have provided a framework to operationalize and quantify the study of social interactions and the associated neural substrates. Method: We investigated brain activation using functional magnetic resonance imaging (fMRI) in unmedicated depressed participants (n = 25) and matched healthy controls (n = 25). During scanning, participants played a behavioural economic paradigm, the Ultimatum Game (UG). In this task, …

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Incidental emotions in moral dilemmas: the influence of emotion regulation.

Recent theories have argued that emotions play a central role in moral decision-making and suggested that emotion regulation may be crucial in reducing emotion-linked biases. The present studies focused on the influence of emotional experience and individual differences in emotion regulation on moral choice in dilemmas that pit harming another person against social welfare. During these "harm to save" moral dilemmas, participants experienced mostly fear and sadness but also other emotions such as compassion, guilt, anger, disgust, regret and contempt (Study 1). Fear and disgust were more frequently reported when participants made deontological choices, whereas regret was more frequently reported when participants made utilitarian choices. In addition, habitual reappraisal negatively predicted deontological choices, and this effect was significantly carried through emotional arousal (Stud…

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Transgression as addiction: religiosity and moral disapproval as predictors of perceived addiction to pornography.

Perceived addiction to Internet pornography is increasingly a focus of empirical attention. The present study examined the role that religious belief and moral disapproval of pornography use play in the experience of perceived addiction to Internet pornography. Results from two studies in undergraduate samples (Study 1, N = 331; Study 2, N = 97) indicated that there was a robust positive relationship between religiosity and perceived addiction to pornography and that this relationship was mediated by moral disapproval of pornography use. These results persisted even when actual use of pornography was controlled. Furthermore, although religiosity was negatively predictive of acknowledging any pornography use, among pornography users, religiosity was unrelated to actual levels of use. A structural equation model from a web-based sample of adults (Study 3, N = 208) revealed similar results.…

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The development of prosocial moral reasoning and a prosocial orientation in young adulthood: concurrent and longitudinal correlates.

We examined stability and change in prosocial moral reasoning (PRM) assessed longitudinally at ages 20/21, 22/23, 24/25, 26/27, and 31/32 years (N = 32; 16 female) using a pencil-and-paper measure of moral reasoning and examined relations of PRM and prosocial behavior with one another and with empathy, sympathy measured with self- and friend reports in adulthood, self- and mother reports of prosocial tendencies in adolescence, and observed prosocial behavior in preschool. Proportions of different types of PRM (hedonistic, approval, stereotypic, internalized) exhibited high mean-level stability across early adulthood, although stereotypic PMR increased with age and hedonistic PRM (a less sophisticated type of PRM) declined over time for males. More sophisticated PMR was positively related to friends' reports of a prosocial orientation concurrently and at age 24/25, as well as self-reports…

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Moral complexity in middle childhood: children's evaluations of necessary harm.

We assessed 5- to 11-year-olds' (N = 76) judgments of straightforward moral transgressions (prototypical harm) as well as their evaluations of complex, hypothetical scenarios in which an actor transgresses in order to prevent injury (necessary harm). The nature of the actor's transgression (psychological or physical harm) varied across participants. Moral judgments and justifications, knowledge of the actor's psychological experience, and their associations were examined. At all ages, children negatively evaluated prototypical harm; judgments of necessary harm became increasingly more forgiving with age as justifications pertaining to the actor's harm decreased. References to the actor's positive actions and children's tendency to coordinate conflicting concerns increased with age, but only when evaluating psychological harm. Across conditions, older children viewed transgressors as hold…

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Developmental relations between sympathy, moral emotion attributions, moral reasoning, and social justice values from childhood to early adolescence.

This study examined the development of sympathy, moral emotion attributions (MEA), moral reasoning, and social justice values in a representative sample of Swiss children (N = 1273) at 6 years of age (Time 1), 9 years of age (Time 2), and 12 years of age (Time 3). Cross-lagged panel analyses revealed that sympathy predicted subsequent increases in MEA and moral reasoning, but not vice versa. In addition, sympathy and moral reasoning at 6 and 9 years of age were associated with social justice values at 12 years of age. The results point to increased integration of affect and cognition in children's morality from middle childhood to early adolescence, as well as to the role of moral development in the emergence of social justice values.

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Selfish or selfless? On the signal value of emotion in altruistic behavior.

Theories that reject the existence of altruism presume that emotional benefits serve as ulterior motives for doing good deeds. These theories argue that even in the absence of material and reputational benefits, individuals reap utility from the feelings associated with doing good. In response to this normative view of altruism, this article examines the descriptive question of whether laypeople penalize emotional prosocial actors. Six studies find that emotion serves as a positive signal of moral character, despite the intrapsychic benefits associated with it. This is true when emotion motivates prosocial behavior (Studies 1, 2, 3, and 5) and when emotion is a positive outcome of prosocial behavior (i.e., "warm glow"; Studies 4, 5, and 6). Emotional actors are considered to be moral because people believe emotion provides an honest and direct signal that the actor feels a genuine concer…

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How much is it going to cost me? Bidirectional relations between adolescents' moral personality and prosocial behavior.

The current study examined bidirectional relations between adolescents' moral personality (prosocial values, self-regulation, and sympathy) and low- and high-cost prosocial behavior toward strangers. Participants included 682 adolescents (M age of child = 14.31, SD = 1.07, 50% female) who participated at two time points, approximately one year apart. Cross-lag analyses suggested that adolescents' values were associated with both low- and high-cost prosocial behavior one year later, self-regulation was associated with high-cost prosocial behavior, and sympathy was associated with low-cost prosocial behavior. Findings also suggested that low-cost prosocial behavior was associated with sympathy one year later, and high-cost prosocial behavior was associated with values. Discussion focuses on reciprocal relations between moral personality and prosocial behavior, and the need to consider a mo…

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Me or you? Neural correlates of moral reasoning in everyday conflict situations in adolescents and adults.

Throughout adolescence, progress in the understanding of the moral domain as well as changes in moral behavior is observable. We tested 16 adolescents (14-16 years of age) and 16 healthy adults (22-31 years of age) on the developmental changes in everyday moral decision making using functional magnetic resonance imaging (fMRI). Using verbal stories describing everyday moral conflict situations, subjects had to decide between a moral standard or a personal desire. In the moral conflict situations, adolescents not only chose significantly more often the hedonistic alternative than adults, but they also reported higher certainty ratings. Contrasted with everyday social conflict situations that required a decision between a social-oriented behavior and a personal need, moral conflict situations induced an activity increase in frontal areas, the middle temporal gyrus, the thalamus, and the pa…

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Attitudes towards euthanasia in Iran: the role of altruism.

Objective: Altruism is arguably the quintessential moral trait, involving willingness to benefit others and unwillingness to harm them. In this study, I explored how altruism and other personality variables relate to acceptance of euthanasia. In addition, I investigated the role of culture in attitudes to subcategorical distinctions of euthanasia. Methods: 190 Iranian students completed the Attitude Towards Euthanasia scale, the HEXACO Personality Inventory-Revised, and an interest in religion measure. Results: Higher scores on altruism, Honesty-Humility, Agreeableness, Conscientiousness and religiousness were associated with viewing euthanasia as unacceptable. As expected, altruism explained unique variance in euthanasia attitude beyond gender, religiosity and broad personality factors. Conclusions: Cultural and individual differences should be taken into consideration in moral psycholo…

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Friendship selection and influence in bullying and defending: effects of moral disengagement.

The current study examined the development of bullying and defending over a 1-year period as related to friends' influence and individual and friends' moral disengagement (i.e., self-justification mechanisms that allow one to avoid moral self-censure of transgressive actions) in children and young adolescents. Via longitudinal social network analysis (RSiena), it was tested whether similarity between friends in bullying and defending developed over time due to friends' influence, while controlling for friendship selection processes, and whether there were differences in these processes between children (age 9-10 years; n = 133; 42.9% girls) and young adolescents (age 11-14 years; n = 236; 40.6% girls). Results showed that individuals selected peers as friends who were similar in bullying and became more similar to friends in bullying over time, but only in early adolescence. Moreover, th…

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The essence of innocence: consequences of dehumanizing Black children.

The social category "children" defines a group of individuals who are perceived to be distinct, with essential characteristics including innocence and the need for protection (Haslam, Rothschild, & Ernst, 2000). The present research examined whether Black boys are given the protections of childhood equally to their peers. We tested 3 hypotheses: (a) that Black boys are seen as less "childlike" than their White peers, (b) that the characteristics associated with childhood will be applied less when thinking specifically about Black boys relative to White boys, and (c) that these trends would be exacerbated in contexts where Black males are dehumanized by associating them (implicitly) with apes (Goff, Eberhardt, Williams, & Jackson, 2008). We expected, derivative of these 3 principal hypotheses, that individuals would perceive Black boys as being more responsible for their actions and as be…

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"What matters most:" a cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma.

To understand Chinese immigrants' experiences with mental illness stigma and mental health disparities, we integrate frameworks of 'structural vulnerability' and 'moral experience' to identify how interaction between structural discrimination and cultural engagements might shape stigma. Fifty Chinese immigrants, including 64% Fuzhounese immigrants who experienced particularly harsh socio-economical deprivation, from two Chinese bilingual psychiatric inpatient units in New York City were interviewed from 2006 to 2010 about their experiences of mental illness stigma. Interview questions were derived from 4 stigma measures, covering various life domains. Participants were asked to elaborate their rating of measure items, and thus provided open-ended, narrative data. Analysis of the narrative data followed a deductive approach, guided by frameworks of structural discrimination and "what matt…

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Moral elevation reduces prejudice against gay men.

Disgust is linked to social evaluation. People with higher disgust sensitivity exhibit more sexual prejudice, and inducing disgust increases sexual prejudice. We tested whether inducing moral elevation, the theoretical opposite of disgust, would reduce sexual prejudice. In four studies (N = 3622), we induced elevation with inspiring videos and then measured sexual prejudice with implicit and explicit measures. Compared to control videos that elicited no particular affective state, we found that elevation reduced implicit and explicit sexual prejudice, albeit very slightly. No effect was observed when the target of social evaluation was changed to race (Black-White). Inducing amusement, another positive emotion, did not significantly affect sexual prejudice. We conclude that elevation weakly but reliably reduces prejudice towards gay men.

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The development of moral emotions and decision-making from adolescence to early adulthood: a 6-year longitudinal study.

Adolescents' emotions in the context of moral decision-making repeatedly have been shown to predict actual behaviour. However, little systematic information on developmental change regarding these emotion expectancies has been available thus far. This longitudinal study investigated anticipated moral emotions and decision-making between the ages of 15 and 21 in a representative sample of Swiss adolescents (N = 1,258; 54 % female; M = 15.30 years). Anticipated moral emotions and decision-making were assessed through a semi-structured interview procedure. Using Bernoulli hierarchical linear modeling, it was found that positive feelings after a moral transgression (i.e., "happy victimizer" responses) decreased over time, whereas positive feelings after a moral decision (i.e., "happy moralist" responses) increased. However, this pattern was contingent upon the moral scenario presented. Syste…

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"Two for flinching": children's and adolescents' narrative accounts of harming their friends and siblings.

This study investigated differences in children's and adolescents' experiences of harming their siblings and friends. Participants (N = 101; 7-, 11-, and 16-year-olds) provided accounts of events when they hurt a younger sibling and a friend. Harm against friends was described as unusual, unforeseeable, and circumstantial. By contrast, harm against siblings was described as typical, ruthless, angry, and provoked, but also elicited more negative moral judgments and more feelings of remorse and regret. Whereas younger children were more self-oriented with siblings and other-oriented with friends, accounts of harm across relationships became somewhat more similar with age. Results provide insight into how these two relationships serve as distinct contexts for sociomoral development.

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An event-related potential study of adolescents' and young adults' judgments of moral and social conventional violations.

The neurocognitive development of moral and conventional judgments was examined. Event-related potentials were recorded while 24 adolescents (13 years) and 30 young adults (20 years) read scenarios with 1 of 3 endings: moral violations, conventional violations, or neutral acts. Participants judged whether the act was acceptable or unacceptable when a rule was assumed or removed. Across age, reaction times were faster for moral than conventional violations when a rule was assumed. Adolescents had larger N2 amplitudes than adults for moral and neutral, but not conventional, acts. N2 amplitudes were larger when a rule was removed than assumed for moral, but not conventional, violations. These findings suggest that the neurocognitive mechanisms underlying moral and conventional judgments continue to develop beyond early adolescence.

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Paradoxical consequences of prohibitions.

Explanations based in attribution theory claim that strong external controls such as parental restrictiveness and punishment undermine moral internalization. In contrast, 3 studies provide evidence that parental punishment does socialize morality, but of a particular sort: a morality focused on prohibitions (i.e., proscriptive orientation) rather than positive obligations (i.e., prescriptive orientation). Study 1 found young adults' accounts of parental restrictiveness and punishment activated their sensitivity to prohibitions and predicted a proscriptive orientation. Consistent with the greater potency of temptations for proscriptively oriented children, as well as past research linking shame to proscriptive morality, Study 2 found that restrictive parenting was also associated with greater suppression of temptations. Finally, Studies 3A and 3B found that suppressing these immoral thoug…

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Shaping legal abortion provision in Ghana: using policy theory to understand provider-related obstacles to policy implementation.

Background: Unsafe abortion is a major public health problem in Ghana; despite its liberal abortion law, access to safe, legal abortion in public health facilities is limited. Theory is often neglected as a tool for providing evidence to inform better practice; in this study we investigated the reasons for poor implementation of the policy in Ghana using Lipsky's theory of street-level bureaucracy to better understand how providers shape and implement policy and how provider-level barriers might be overcome. Methods: In-depth interviews were conducted with 43 health professionals of different levels (managers, obstetricians, midwives) at three hospitals in Accra, as well as staff from smaller and private sector facilities. Relevant policy and related documents were also analysed. Results: Findings confirm that health providers' views shape provision of safe-abortion services. Most promin…

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