Acceso usuarios
Stephanie Sue Nakazaki Granda, Susana del Mar Frisancho Hidalgo
El objetivo de este estudio fue identificar y describir el razonamiento moral de un grupo de adultos, siete hombres y tres mujeres de entre 30 y 60 años, de la ciudad de Lima, Perú, acerca de las medidas preventivas que el gobierno decretó para enfrentar el COVID-19. Se utilizó una entrevista cualitativa semiestructurada, construida para esta investigación, compuesta por tres situaciones de conflicto relacionadas a tres diferentes medidas preventivas del COVID-19: el uso de mascarillas, el aislamiento domiciliario de las personas contagiadas, y la vacunación. Las entrevistas se realizaron a través de la plataforma Zoom y se apoyaron con material gráfico. Los resultados evidencian que los participantes exhiben una variedad de posturas y formas de razonar moralmente acerca de las medidas preventivas del COVID-19, algunas de ellas principistas y otras convencionales e instrumentales. Algunos participantes se adhieren al cumplimento de dichas medidas por razones morales orientadas al reconocimiento de derechos, la protección del cuerpo y de la salud, y la consecución del bien común, mientras que otros justifican su cumplimento solamente por el seguimiento de reglas y normas, evitar sanciones, o para alcanzar fines o metas individuales tales como no tener que ir a trabajar. La variabilidad encontrada en este estudio, en cuanto a los tipos de posturas y las formas de razonar moralmente sobre las medidas preventivas del COVID-19, plantea la necesidad de repensar la educación moral y ciudadana para incluir estas temáticas, así como rediseñar las estrategias comunicacionales sobre salud pública en la actual o en futuras pandemias para incluir en ellas elementos morales.
In March 2020, the World Health Organization declared COVID-19 a pandemic. Due to the absence of an initial specific treatment to combat it, prevention measures such as mask usage and frequent hand washing became the primary approach adopted by governments.
Citizens' responses to these preventive measures exhibited a lack of uniformity. While some individuals accepted and adhered to the measures even when they weren't mandatory, others rejected these regulations. Additionally, as vaccines became accessible, certain individuals displayed minimal willingness to undergo vaccination.
It is well-established that individuals' adherence to medical instructions plays a pivotal role in disease prevention and the promotion of overall health. Numerous factors have been identified as influencing this compliance, including socioeconomic status, treatment complexity, knowledge or beliefs about the disease, and personality traits. Research has revealed variations in compliance with health risk measures based on individuals' levels of moral reasoning. Those who exhibit principled reasoning are adept at recognizing the moral aspects of medical situations and consequently adhere to care guidelines, whereas those with less developed moral reasoning tend to be less vigilant.
In the context of COVID-19, studies indicate that adherence to preventive measures is closely linked to individuals' perceived sense of moral responsibility.
From a constructivist framework, the aim of this study was to identify and describe the moral reasoning of a group of adults concerning COVID-19 preventive measures. This qualitative study employed a semi-structured interview format comprising scenarios that involved conflicts related to COVID-19 preventive measures. The participants consisted of 10 adults, including 3 women and 7 men, aged between 30 and 60 years, residing in Lima since the onset of the pandemic. Informed consent procedures were established, and participant approval was obtained. Conducted via the Zoom platform, the interviews were recorded and subsequently transcribed. Each interview, held during March and April 2022, lasted approximately 60 minutes.
The interview focused on three specific scenarios: 1) The decision to wear a mask to enter a theater, balancing individual rights and freedoms against its use; 2) The decision to report a colleague with COVID-19 at work, weighing the need for confidentiality against public health concerns, and 3) The decision to be vaccinated for a return to classes, considering religious beliefs that oppose vaccination. The data analysis and interpretation were conducted within the constructivist paradigm, aiming to illuminate the moral reasoning underlying participants' responses.
To analyze the gathered information, deductive thematic analysis was employed. This approach involves establishing a set of predefined categories derived from theory, which are subsequently utilized for coding, analysis, and interpretation. Drawing from Kohlberg's model of moral development, the responses were categorized into three distinct types: instrumental (compliance with measures driven by personal convenience or fear of repercussions), conventional (adherence to regulations to fulfill societal norms or avert disorder), and principled (commitment to preventive measures based on recognition of their equity, appropriateness for the collective well-being, and the rights of all individuals). The interviews were subject to manual coding by the authors of the article. In cases of discordant coding, the criteria were thoroughly reviewed, and efforts were made to achieve consensus.
The findings indicate that, concerning cases 1 and 2, a majority of the participants were able to discern the moral aspect. Conversely, in case 3, an equal number of participants offered arguments from a principled perspective as those who did not. Among those who acknowledged the moral dimension across all cases, their justifications for adhering to preventive measures were primarily grounded in principled considerations. This was in contrast to mere conventional motivations or self-interest. Moreover, the results highlight the existence of diverse stances and rationales behind individuals' adherence to preventive measures, even in situations where such compliance is obligatory. The implications of these outcomes for potential future pandemics are deliberated upon.
COVID-19, moral reasoning, preventive measures, moral development, public health
