Luppo Kuillman

Re-assessing the validity of the Moral Sensitivity Questionnaire 37 2 hypothesize that: ■ H2: Neither the paternalistic nor the deliberate attitude scale is expected to have any significant overlapwith the level ofmoral reasoning (DIT-N2). Convergent validity We assume that deliberative attitude is related to several ethical tendencies of people. After all, the main characteristic of a deliberative attitude to value a respectful relationship with patients. Hence, deliberate patient-centered decision-making is expected to more strongly possess preferences and traits that are ethics-related. For example, they may be more likely to adhere to the fundamental principle of “First, do not harm”; they may be more likely to value ethical considerations in care and are less inclined to use mechanisms of moral disengagement. We therefore hypothesize that: ■ H3.1: There is a positive correlation between amoral deliberate attitude and the BCPH scale. ■ H3.2: There is a positive correlation between a moral deliberate attitude and theEAS. ■ H3.3: There is a negative correlation between the moral deliberate attitude and the MDS. On the other hand, a paternalistic attitude may differently relate to ethical tendencies. Because people with a paternalistic attitude are more likely to avoid empathizing with the patient’s dilemmas and prefer rules and regulations, they may exhibit little inclination to advocate the need for ethics in patient care. Hence, they may also have a weaker tendency to control impulses of morally disengaged behavior. We therefore hypothesize that: ■ H4.1: The NPs’ and PAs’ paternalistic attitudes are expected to have no correlation with the EAS. ■ H4.2: The NPs’ and PAs’ paternalistic attitudes are expected to have a positive correlation with the MDS. Despite the expectation that a paternalistic attitude is negatively related to the need to advocate for ethics and positively to moral disengagement, this does not necessarily mean that they do not care about the “First, do not harm” principle. In fact, people who score high on paternalism may also adhere to this principle, although they try to achieve this in different ways than people who score high of moral deliberation