Gilligan's Research on Moral Development

Understanding Values in Nursing

• Values clarification enhances moral agency and decision-making in nursing.
• Internalized values become part of a nurse's identity and influence their decision-making and communication.
• Awareness of personal values aids in exercising moral agency and accountability.
• Values conflict can lead to internal or interpersonal conflict, affecting patient care.

Impact of Institutional Values on Nurses

• Overt values are communicated through philosophy and policy statements.
• Covert values are implicit expectations not in writing, discovered through attitudes or controversies.
• Institutional values can restrict nurses' ability to act from their personal values.
• Nurses may prioritize patient care goals over institutional goals, leading to conflict.

Employment and Personal Values

• Nurses should identify how their personal values align with or differ from those of the institution.
• Conflicting values can lead to internal or interpersonal conflict.

Kohlberg's Theory of Moral Development

• The theory proposes a progression in moral reasoning across three levels: preconventional, conventional, and postconventional.
• Level I: Preconventional focuses on egocentric reasoning with two stages: punishment and obedience, and individual instrumental purpose and exchange.
• Level II: Conventional focuses on social conformity with two stages: mutual interpersonal expectations, relationships, and conformity.
• Level III: Postconventional and principled focuses on universal moral principles with two stages: a priori rights and social contract or utility.

Gilligan's Study on Women's Moral Decision Making

• Women approach moral decision-making differently from men, using an ethic of caring grounded in relationship and responsibility.
• The care perspective is the default perspective that women use and feel most comfortable with.
• Gilligan's research proposes a progression of moral thinking through three phases: survival, focusing on goodness, and reflective understanding of care.

Fowler's Perspective on Faith Development

• Faith development is a result of an integration of ways of knowing and valuing.
• Fowler proposes six stages of faith, starting with intuitive faith in early childhood and progressing to universalizing faith.
• Each stage builds on the previous one, with a focus on integration and responsibility.

Ethic of Care vs. Ethic of Justice in Nursing

• Justice focuses on separateness and objective rules, while care focuses on natural relatedness with others.
• Both perspectives offer different perspectives for examining problems, offering a comprehensive moral perspective.
• An ethic of care reflects nursing's experience more than a primary focus on justice.

Ethical Decision Making in Nursing

• Ethical decision-making is a socially and culturally mediated process that involves emotion and reason.
• Understanding different perspectives helps appreciate personal approaches to ethical dilemmas and prevent inappropriate judgments.
• Nurses are responsible for assessing individuals' knowledge, competence, and experience, and monitoring and evaluating care quality.

Dilemma and Ethical Dilemma in Nursing

• A dilemma is a problem requiring a choice between two equally unfavorable and mutually exclusive options.
• An ethical dilemma occurs when options include conflicting moral claims, such as a terminally ill patient deciding between life-preserving measures or support for a peaceful death.
• Conflicting moral claims can occur between obligations, principles, duties, rights, loyalties, etc.