Luppo Kuillman

Chapter 6 132 between Ethics Advocacy and the reporting reprehensible conduct as a variable to be explained. In other words, Ethics Advocacy only increased the intentions to report reprehensible conduct if people at the same time felt they had control over situations of preventing harm. This is an important finding and adds to the understanding that the ethical decision-making process is not only rational, but also involves personal feelings and perceptions which may play intervening roles in the realization of (un) ethical choices. In Chapter 5, the indicator of (un)ethical conduct was introduced as the construct of ‘Yielding to Pressure.’ Whereas in Chapter 4, the dependent variables of ‘reporting reprehensible conduct’ were about the observation of unethical conduct outside the self, the ‘yielding to pressure’ indicators in Chapter 5 are linked to the own set of moral standards. The two vignettes contained a situation in which there is a moral conflict where a choice had to be made between sticking to one’s own standards, norms, and values or going along with the demanding patient or pressure from the immediate work environment. With the primary aim of validating the predictive values of the MSQ-DELIB and MSQ-PATER scales (as reported in Chapter 2), we can conclude that the main finding in this study is that morally deliberative attitudes influence the risk that healthcare providers give in to pressure exerted by patients. However, the direction of that influence depended on the specific behavioral scenario presented to them in the study. In a scenario involving a direct provider-patient interaction moral deliberation increased the extent to which one yielded to pressure. In the scenario where it was about pressure from colleagues, moral deliberate attitude lowered the degree to which one yielded pressure. However, the reason as to why these relations behave in an opposite manner warrant subsequent research. Notwithstanding, with this finding, a new indicator of moral sensitivity/ awareness will be added to the international pile of literature regarding this usable indicator within the FCM. 6.3 Strengths and limitations The strengths of this doctoral work are its educational and professional relevance for both the PA also NP profession, the consistent use of constructs derived from widely used and established theories (FCM, moral disengagement theory, and theory of planned behavior), but also the methodological rigor.