Luppo Kuillman

General Introduction 17 1 The MIM measures both of these dimensions of self-importance. The MIM is a 10-question self-report instrument that asks the respondent to keep in mind the following nine characteristics that might describe him/herself or any person: caring, friendly, helpful, compassionate, generous, honest, fair, hardworking, and kind. Respondents are asked to visualize in their minds the kind of person who has such characteristics and asks them to imagine how that person would think, feel, and act. Respondents are then asked to rate the 10 statements on a seven-point Likert scale, from “strongly disagree” (=1) to “strongly agree” (=7). These statements assess the extent to which morality is important for the participant’s sense of self-identity in terms of two dimensions, public and private. These two dimensions are defined in the measurement as “Symbolization,” or public, and “Internalization,” or private. However, regarding the component ‘moral motivation, ’ little research is known to be conducted among health professionals, despite the fact that several studies conclude that moral identity is a predictor of moral action (Damon & Gregory, 1997). For this reason, we developed a context-specific indicator for measuring moral identity in this doctoral research, which we introduce as Ethics Advocacy (EA). This novel concept is defined as: “the importance that individuals attach to ethicality within the specific context of healthcare delivery.” More specifically, EA entails the extent to which healthcare professionals consider it important for attention to be paid to the ethical aspects of care within their organization and during patient contact. The link to moral identity is a logical one, especially because EA reflects an internalized set of moral principles. In Chapters 2 and 4, EA is used as an explanatory variable. 1.3.4 Conceptualization and operationalization of Moral Character and implementation Moral Character and ethical implementation compose the fourth integrative component of the FCM, which may be conceptualized as having the moral courage to act upon one’s moral motivations and judgment. As described by Bebeau, it relates to being strong-willed and not yielding to pressure. As such, it “attends to the importance of character to effective and responsible care (Bebeau, 2002). Since character may be viewed as one of the five factors that create a personality (McDougall, 1932), in this present doctoral work, it was found plausible to measure personality traits as a proxy for character, and in line with that: the attitude or behavior. A trait-based approach of defining moral character can be underlined by the rather recent operational